Síndrome Metabólico. Bases clínicas y fisiopatológicas para un enfoque terapéutico racional.

Resumen

The raising prevalence of obesity and unhealthy lifestyles has made the metabolic syndrome a pandemia. Regardless of the diagnostic criteria, the metabolic syndrome is found at least in 20% of the population.

The adipose tissue plays an important role in the insulin resistance found in this syndrome. Free fatty acid released by intra-abdominal adipocytes produces an inflammatory and pro-thrombotic response and the persistance of the insulin resistance state, phenomenon termed lipotoxicity. This altered phenotype explains the development of the different components of the metabolic syndrome, like hypertension, dyslipidemia and altered glucose metabolism.

The treatment is based on bodyweight loss and the adquisition of healthy lifestyle patterns. A balanced diet, physical activity and avoidance of smoking are key features in the management of these patients. At this state of knowledge, the components of the metabolic syndrome must be treated separately, reaching the specific goals of each condition. The use of drugs with pleiotropic effects, that inhibits the renin angiotensin aldosterone axis or acts on the peroxisome proliferator-activated receptors (PPAR) seems promising and leads to the study of new therapies for this patients.