The term metabolic syndrome (MS) is used to describe a group of metabolic disorders: insulin resistance (IR) or hyperglycemia, abdominal obesity, dyslipidemia (high very-low-density lipoprotein-triglyceride [VLDL-TG] concentration and low plasma high -density lipoprotein cholesterol [HDL-C]), and essential hypertension (HTN).These factors are important because each component increases the risk of development of type 2 diabetes mellitus (DM) and cardiovascular disease (CVD).
Studies showed that most subjects with type 2 DM had resistance to insulin action in adipose tissue, liver, and skeletal. Curiously, insulin-mediated stimulation of amino acid deposition may be normal in subjects with DM, but it is impaired in subjects with other forms of IR, such as that of the human immunodeficiency virus (HIV)– associated MS.
Reaven proposed that increased insulin concentrations could activate metabolic pathways and consequence in dyslipidemia and HTN. 83% of hypertensive subjects were insulin resistant or obese, HTN was strongly communicated with both fasting and post glucose hyperinsulinemia and the effects of HTN, glucose tolerance, and obesity were linearly additive to the total serum insulin concentration.
Also Insulin elevates renal sodium retention, thus promoting fluid retention and causes mild edema in patients with previously poorly controlled DM. Insulin infusion increases heart rate and sympathetic nervous system activity, which, in turn, increases myocardial contractility and vascular tone and promotes salt retention via secretion of renin. Conversely, intravenous insulin may also dilate peripheral blood vessels, although this effect is blunted in DM Obesity may participate to HTN through release of adipocyte-related factors. Adipocytes contain angiotensinogen, which may not only induce IR and HTN but may also stimulate aldosterone secretion. Components or metabolites of FAs may also contribute, such as an epoxy-keto derivative of linoleic acid, which is capable of stimulating aldosterone secretion Lifestyle interventions, including weight loss, in particular loss of abdominal fat by diet and resistance or aerobic exercise are modestly effective at increasing HDL-C concentrations and improve insulin sensitivity.
Linking the effects of different foods in a varied diet is very difficult. Cooking methods, food components interactions, lack of variety and balance of nutrients such as excessive consumption of fat and carbohydrates and minerals ( sodium) have well-known role in MS and must be modified.