Horm Metab Res 2007; 39(11): 777-780
DOI: 10.1055/s-2007-990312
Mini Review

© Georg Thieme Verlag KG Stuttgart · New York

The Metabolic Syndrome - A Global Challenge for Prevention

P. E. H. Schwarz 1 , M. Reimann 1 , J. Li 1 , A. Bergmann 1 , J. Licinio 2 , M.-L. Wong 2 , S. R. Bornstein 1
  • 1Department of Internal Medicine III, Clinic for Endocrinology, Diabetes and Metabolism, Technical University Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany
  • 2Department of Psychiatry & Behavioural Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
Further Information

Publication History

received 20.08.2007

accepted 03.09.2007

Publication Date:
09 November 2007 (online)

Abstract

In the last years we have learned a lot about the pathopysiology of a cluster of the diseases called Metabolic Syndrome but currently an exciting discussion debates the Metabolic Syndrome in a light of a mystery of medicine or a clinical paradigm with a controversary about diagnostic, treatment or preventive procedure. There is now convincing evidence that prevention is the most important and effective way to reduce the personal and socio-economic burden of the Metabolic Syndrome and its associated complications. Still, it is currently not clear how to implement preventive interventions into clinical practice but will require an integrated and transdisciplinary approach on an international level in order to efficiently reduce premature morbidity and mortality. Nevertheless, global strategies are still lacking but are needed to tackle inequalities in health between industrialized countries and the developing world. A global health strategy has to take into account political, epidemiological, environmental, infrastructural and genetic aspects. The Metabolic Syndrome is not a mystery - it is a clinical paradigm and global challenge.

References

  • 1 Bornstein SR, Wong ML, Licinio J. 150 years of Sigmund Freud: What would Freud have said about the obesity epidemic?.  Mol Psychiatry. 2006;  11 1070-1072
  • 2 Hanefeld M, Ceriello A, Schwarz PE, Bornstein SR. The metabolic syndrome-a postprandial disease?.  Horm Metab Res. 2006;  38 435-436
  • 3 Schwarz PE, Schwarz J, Bornstein SR, Schulze J. Diabetes prevention-from physiology to implementation.  Horm Metab Res. 2006;  38 460-464
  • 4 Korenblum W, Barthel A, Licinio J, Wong ML, Wolf OT, Kirschbaum C, Bornstein SR. Elevated cortisol levels and increased rates of diabetes and mood symptoms in Soviet Union-born Jewish immigrants to Germany.  Mol Psychiatry. 2005;  10 974-975
  • 5 Schwarz PE, Bornstein SR. Pre-diabetes and metabolic syndrome in Germans.  Horm Metab Res. 2006;  38 359
  • 6 Valensi P, Schwarz EH, Hall M, Felton AM, Maldonato A, Mathieu C. Pre-diabetes essential action: a European perspective.  Diabetes Metab. 2005;  31 606-620
  • 7 Schwarz PE. Report from the Congress of the American Diabetes Association (ADA): Orlando 2005 - 65th Annual Scientific Sessions in San Diego, CA, USA, June 10-14th 2005.  Exp Clin Endocrinol Diabetes. 2005;  113 475-479
  • 8 Schwarz PE. Congress report from the American Diabetes Association 66th Annual Scientific Sessions in Washington, USA.  Exp Clin Endocrinol Diabetes. 2006;  114 605-610
  • 9 Hanefeld M. LW. Das Metabolische Syndrom.  Dtsch Gesundh Wesen. 1981;  36 545-551
  • 10 Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease.  Diabetes. 1988;  37 1595-1607
  • 11 World Health Organization .Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO Consultation 1999
  • 12 Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III).  JAMA. 2001;  285 2486-2497
  • 13 Alberti KG, Zimmet P, Shaw J. International Diabetes Federation: a consensus on Type 2 diabetes prevention.  Diabet Med. 2007;  24 451-463
  • 14 Zimmet P, Magliano D, Matsuzawa Y, Alberti G, Shaw J. The metabolic syndrome: a global public health problem and a new definition.  J Atheroscler Thromb. 2005;  12 295-300
  • 15 Rudofsky  Jr  G, Reismann P, Schiekofer S, Petrov D, Eynatten M, Humpert PM, Isermann B, Muller-Hoff C, Thai TP, Lichtenstein S, Bartsch U, Hamann A, Nawroth P, Bierhaus A. Reduction of postprandial hyperglycemia in patients with type 2 diabetes reduces NF-kappaB activation in PBMCs.  Horm Metab Res. 2004;  36 630-638
  • 16 Haslbeck KM, Schleicher E, Bierhaus A, Nawroth P, Haslbeck M, Neundorfer B, Heuss D. The AGE/RAGE/NF-(kappa)B pathway may contribute to the pathogenesis of polyneuropathy in impaired glucose tolerance (IGT).  Exp Clin Endocrinol Diabetes. 2005;  113 288-291
  • 17 Schiekofer S, Franke S, Andrassy M, Chen J, Rudofsky G, Schneider JG, Eynatten M von, Wendt T, Morcos M, Kientsch-Engel R, Stein G, Schleicher E, Nawroth PP, Bierhaus A. Postprandial mononuclear NF-kappaB activation is independent of the AGE-content of a single meal.  Exp Clin Endocrinol Diabetes. 2006;  114 160-167
  • 18 Kamari Y, Grossman E, Oron-Herman M, Peleg E, Shabtay Z, Shamiss A, Sharabi Y. Metabolic stress with a high carbohydrate diet increases adiponectin levels.  Horm Metab Res. 2007;  39 384-388
  • 19 Kyrou I, Tsigos C. Stress mechanisms and metabolic complications.  Horm Metab Res. 2007;  39 430-438
  • 20 Schuppenies A, Schwarz P, Bornstein SR. Seasonal affective disorder and HPA axis disturbance.  Horm Metab Res. 2006;  38 434
  • 21 Ohmura E, Hosaka D, Yazawa M, Tsuchida A, Tokunaga M, Ishida H, Minagawa S, Matsuda A, Imai Y, Kawazu S, Sato T. Association of free fatty acids (FFA) and tumor necrosis factor-alpha (TNF-alpha) and insulin-resistant metabolic disorder.  Horm Metab Res. 2007;  39 212-217
  • 22 Schmitz G, Langmann T. Metabolic learning in the intestine: adaptation to nutrition and luminal factors.  Horm Metab Res. 2006;  38 452-454
  • 23 Ansurudeen I, Kopprasch S, Ehrhart-Bornstein M, Willenberg HS, Krug AW, Funk RH, Bornstein SR. Vascular-adrenal niche - endothelial cell-mediated sensitization of human adrenocortical cells to angiotensin II.  Horm Metab Res. 2006;  38 476-480
  • 24 Slama G, Elgrably F, Kabir M, Rizkalla SW. Role of low-glycemic-index foods in improving overall glycemic control in type 1 and type 2 diabetic patients and correcting excessive postprandial hyperglycemia.  Horm Metab Res. 2006;  38 465-468
  • 25 Pistrosch F, Koehler C, Wildbrett J, Hanefeld M. Relationship between diurnal glucose levels and HbA1c in type 2 diabetes.  Horm Metab Res. 2006;  38 455-459
  • 26 Lamounier-Zepter V, Ehrhart-Bornstein M, Bornstein SR. Metabolic syndrome and the endocrine stress system.  Horm Metab Res. 2006;  38 437-441
  • 27 Bornstein SR, Schuppenies A, Wong ML, Licinio J. Approaching the shared biology of obesity and depression: the stress axis as the locus of gene-environment interactions.  Mol Psychiatry. 2006;  11 892-902
  • 28 Reichel A, Schwarz J, Schulze J, Licinio J, Wong ML, Bornstein SR. Depression and anxiety symptoms in diabetic patients on continuous subcutaneous insulin infusion (CSII).  Mol Psychiatry. 2005;  10 975-976
  • 29 Wenying Y, Zhaojun Y. Obesity and hypertension as two anthropometric predictors for metabolic syndrome.  Horm Metab Res. 2006;  38 469-470
  • 30 Schwarz PE, Schwarz J, Schuppenies A, Bornstein SR, Schulze J. Development of a diabetes prevention management program for clinical practice.  Public Health Rep. 2007;  122 258-263
  • 31 Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.  N Engl J Med. 2002;  346 393-403
  • 32 Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.  N Engl J Med. 2001;  344 1343-1350
  • 33 Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial.  Lancet. 2002;  359 2072-2077
  • 34 Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, Hu ZX, Lin J, Xiao JZ, Cao HB, Liu PA, Jiang XG, Jiang YY, Wang JP, Zheng H, Zhang H, Bennett PH, Howard BV. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study.  Diabetes Care. 1997;  20 537-544
  • 35 Snitker S, Watanabe RM, Ani I, Xiang AH, Marroquin A, Ochoa C, Goico J, Shuldiner AR, Buchanan TA. Changes in insulin sensitivity in response to troglitazone do not differ between subjects with and without the common, functional Pro12Ala peroxisome proliferator-activated receptor-gamma2 gene variant: results from the Troglitazone in Prevention of Diabetes (TRIPOD) study.  Diabetes Care. 2004;  27 1365-1368
  • 36 Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the preven-tion of type 2 diabetes in obese patients.  Diabetes Care. 2004;  27 155-161
  • 37 Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1).  Diabetologia. 2006;  49 289-297
  • 38 Schwarz PEH, Schwarz J, Bornstein SR, Schulze J. Prevention of type 2 diabetes: what challenges do we have to address?.  J. Public Health. 2005;  13 303-308
  • 39 Schwarz PE, Schuppenies A, Gruhl U, Hoffmann R, Bornstein SR, Schulze J, Landgraf R. Prevention of type 2 diabetes in Germany. Ideas, evidence, implementation.  Med Klin (Munich). 2006;  101 730-736
  • 40 Schwarz P. Targeted diabetes prevention in high risk groups: pro.  Dtsch Med Wochenschr. 2005;  130 1103
  • 41 Roubideaux Y, Buchwald D, Beals J, Middlebrook D, Manson S, Muneta B, Rith-Najarian S, Shields R, Acton K. Measuring the quality of diabetes care for older american indians and alaska natives.  Am J Public Health. 2004;  94 60-65
  • 42 Schwarz PE, Bornstein SR, Hanefeld M. Elevated fasting glucose levels predicts IGT and diabetes also in middle-age subjects.  Diabetes Res Clin Pract. 2007;  77 148-150
  • 43 Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, Hamalainen H, Harkonen P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study.  Lancet. 2006;  368 1673-1679
  • 44 Saaristo T, Peltonen M, Lindstrom J, Saarikoski L, Sundvall J, Eriksson JG, Tuomilehto J. Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glu-cose tolerance and metabolic syndrome.  Diab Vasc Dis Res. 2005;  2 67-72
  • 45 Schwarz PEH, Li J, Wegner H, Bornstein SR, Lindström J, Tuomilehto J. An accurate risk score based on anthropometric, dietary, and lifestyle factors to predict the development of type 2 diabetes, response to schulze et al.  Diabetes Care. 2007;  30 e87
  • 46 Schwarz PE, Peltonen M. Prevention of Type 2 diabetes - Lessons we have Learnt for Implementation.  Horm Metab Res. 2007;  39 636-641
  • 47 Schwarz PE, Govindarajalu S, Towers W, Schwanebeck U, Fischer S, Vasseur F, Bornstein SR, Schulze J. Haplotypes in the Promoter Region of the ADIPOQ Gene are Associated with Increased Diabetes Risk in a German Caucasian Population.  Horm Metab Res. 2006;  38 447-451
  • 48 Rudofsky  Jr  G, Schrodter A, Voron’ko OE, Schlotterer A, Humpert PM, Tafel J, Nawroth PP, Bierhaus A, Hamann A. Promoter polymorphisms of UCP1, UCP2, and UCP3 are not associated with diabetic microvascular complications in type 2 diabetes.  Horm Metab Res. 2007;  39 306-309
  • 49 Schwarz PE, Towers GW, Fischer S, Govindarajalu S, Schulze J, Bornstein SR, Hanefeld M, Vasseur F. Hypoadiponectinemia is associated with progression toward type 2 diabetes and genetic variation in the ADIPOQ gene promoter.  Diabetes Care. 2006;  29 1645-1650

Correspondence

Dr. P.E.H. Schwarz

Division of Endocrinology

Department of Medicine III

Medical Faculty Carl-Gustav-Carus

Technical University Dresden

01307 Dresden

Germany

Phone: +49/351/458 27 15

Fax: +49/351/458 73 19

Email: peter.schwarz@uniklinikum-dresden.de

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