View source for Metabolic syndrome

==Background==
*Prothrombotic, proimflammatory state
*May be associated with elevated CRP, IL-6, and tissue plasminogen activator, which may be associated with increased risk of cardiovascular disease and type 2 diabetes 
**Markers not shown to be of utility in the ED

==Clinical Features==
''Although several diagnostic features exist, below is the most widely accepted: The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III)''
*'''Diagnostic Criteria''' - 3 or more of the following:
**Waist circumference >/=102 cm in men or >/=88 cm in women
**Plus 3 of the following:
**Fasting blood glucose >/= to 100 mg/dL or requiring treatment for elevated blood glucose
**HDL </=40 in men or </=50 in women
**TGs >/=150 mg/dL
**BP >/= 130/85 or requiring drug treatment for HTN

==Differential Diagnosis==
*[[Hypertension]]
*Hyperlipidemia
*[[Hyperglycemia]]
*[[Hypothyroidism]]
*Obstructive Sleep Apnea
*Type 2 [[DM]]
*[[Pheochromocytoma]]
*Glucagonoma

==Evaluation==
*Not an ED diagnosis!
*Evaluate for sequelae of associated diseases (e.g. cardiovascular disease, DM) as appropriate
*Non-ED workup may include:
**BMP
**HbA1c
**Lipid panel
**TSH
**+/- Polysomnography to evaluate for OSA

==Management==
*Lifestyle modification
*[[Metformin]]
*BP control(e.g. [[ACEi]] or ARBs}
*OSA treatment
*Depending on the level of obesity, and severity of the condition bariatric surgery may be advantageous to the patient
*Possible referral to obesity management clinic

==Disposition==
*Discharge with outpatient follow-up

==External Links==


==References==
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[[Category:Endocrinology]]