Pozvánka

Vnitr Lek 2009, 55(7-8):617  

Prof. MUDr. Jan Petrášek, DrSc. - 80 let

Štěpán Svačina, Petr Sucharda

Vnitr Lek 2009, 55(7-8):680  

Metabolic syndrome

M. Souček

Vnitr Lek 2009, 55(7-8):618-621  

Metabolic syndrome (MS) has become one of the topical health issues in developed countries. This arises from its increasing prevalence in the population linked to poor lifestyles (stress, overeating, lack of physical activity, smoking) and from its proven significantly negative association with the development of atherosclerosis and thus increased cardiovascular mortality and morbidity. Nevertheless, the approaches to effective MS prevention are known as are the ways of treating and preventing MS sequelae. Prerequisite, however, is an early diagnosis of MS that should become integral to common clinical practice of internal as well as general medicine...

Obesity treatment in metabolic syndrome patients

Š. Svačina

Vnitr Lek 2009, 55(7-8):622-625  

Fat accumulation is an important pathogenetic factor in metabolic syndrome. Weight reduction, at the same time, has a positive effect on metabolic syndrome components. Lifestyle changes are important in the treatment of obesity although they are usually unlikely to provide permanent effect. At present, bariatric surgery and pharmacotherapy represent easily accessible and effective treatment options. In addition, bariatric surgery often results in full remission of type 2 diabetes. Unlike older anti-obesity agents, currently available anti-obesitics sibutramine and orlistat might be taken long-term for years, allowing avoidance of the typical weight...

Lipid-lowering treatment in metabolic syndrome

T. Štulc, R. Češka

Vnitr Lek 2009, 55(7-8):626-630  

During the last decades, metabolic syndrome has become an important healthcare problem worldwide. Main components of metabolic syndrome are insulin resistance (resulting often in impaired glucose tolerance and diabetes mellitus), dyslipidemia, hypertension and abdominal obesity. Incidence of metabolic syndrome is high and it substantially increases the risk of cardiovascular diseases. Dyslipidemia is a prominent factor contributing to the increased cardiovascular risk in metabolic syndrome, and lipid-lowerign therapy plays an important role in treating patients with this disorder. Most patients with dyslipidemia are treated with statins and/or fibrates....

Treatment of hypertension in metabolic syndrome

J. Widimský jr.

Vnitr Lek 2009, 55(7-8):631-635  

Hypertension in metabolic syndrome is common. Basic principles of therapeutic approach like decrease of body weight are discussed. Goal blood pressure levels are ≤ 130/80 mm Hg. ACE-inhibitors/AT₁-blockers are considered drugs of choice. In most cases it is necessary to combine at least two drugs. Preferred combination is ACE-inhibitor/AT₁-blocker + calcium channel blocker.

Treatment of diabetes in metabolic syndrome

T. Pelikánová

Vnitr Lek 2009, 55(7-8):637-645  

Hyperglycaemia is a typical feature of metabolic syndrome (MeTS) and one of its independent diagnostic criteria. The term includes impaired glucose homeostasis (impaired fasting glucose and impaired glucose tolerance) and type 2 diabetes mellitus. Although glycaemic control has been shown to lower the risk of microvascular events, the effect of intensive glycaemic control on macrovascular outcomes is less clear. Epidemiological studies show hyperglycaemia, particularly the postprandial one, to be a clear risk factor for cardiovascular (CV) mortality and morbidity. However, the intervention studies are less conclusive. The large interventional studies...

Metabolic syndrome and the liver (NAFLD/NASH)

P. Hůlek, I. Dresslerová

Vnitr Lek 2009, 55(7-8):646-649  

Metabolic syndrome (MS) is one of the most prevalent disease states in the so-called developed countries and is closely associated with the incidence of cardiovascular as well as other diseases. Predominant sign is the abdominal type of obesity with increased visceral fat mass and the associated insulin resistance. Glucose metabolism disorder, dyslipidemia and arterial hypertension are other important attributes. Metabolic syndrome is also closely associated with the liver steatosis, mostly benign and reversible liver disease. Nevertheless, uncomplicated steatosis may, under certain conditions, progress to inflammation and the disease may, through...

Anxious-depressive disorders and metabolic syndrome

H. Rosolová, J. Podlipný

Vnitr Lek 2009, 55(7-8):650-652  

Anxiety and depressive behavioural disorders often occur concomitantly and their incidence in the general population as well as in chronically ill is higher than anticipated. Pilsen study of male and female patients (N = 1,050) selected from a population-based sample of the primary prevention survey PILS III (Pilsen Longitudinal Study III) had proven an existence of associations between depressive behavioural disorder and metabolic syndrome (MS). Depressive disorders were nearly twice as frequent in patients with MS compared to individuals without MS (RR = 1.85; CI: 1.11-3.10). Patients with psychiatric disorders were excreting more cortisol in the...

Metabolic syndrome and cardiovascular disease

J. Špinar, J. Vítovec

Vnitr Lek 2009, 55(7-8):653-658  

We provide an overview of the current views on the association between metabolic syndrome and cardiovascular disease. Insulin resistance, frequently onsetting from obesity and associated hypercholesterolemia, hypertension and diabetes mellitus, is the common denominator. We also highlight another risk factor - heart rate, closely related to the prognosis of healthy individuals, patients with hypertension and patients following myocardial infarction. Finally, we present the results of the CRUSADE study that has clearly described the association between obesity and age and the first manifestation of the ischemic heart disease.

Chronic mild inflammation links obesity, metabolic syndrome, atherosclorosis and diabetes

M. Anděl, J. Polák, P. Kraml, P. Dlouhý, V. Štich

Vnitr Lek 2009, 55(7-8):659-665  

Chronic low grade inflammation is relatively new concept in metabolic medicine. This concept describes the relations between the inflammation and adipose tissue, insulin resistence, atherosclerosis and type 2 diabetes mellitus. Macrophages and lymphocytes deposed in adipose tissue produce proinflammatory cytokines which directly or through the CRP liver secretion are targeting endothelial cells, hepatocytes and β cells of Langerhans islets of pancreas. The dysfunction of these cells follows often further disturbances and in case of β cells - the cell death. The connection between the adipose tissue insulin resistence, atherosclerosis and...

Laboratory markers of metabolic syndrome in clinical practice

V. Soška

Vnitr Lek 2009, 55(7-8):666-669  

The incidence of metabolic syndrome is evidenced by the presence of three out of five criteria:larger waistline, elevated blood pressure, raised triglyceride levels, reduced HDL-cholesterol and raised fasting glycaemia (or diabetes mellitus). Laboratory picture of metabolic syndrome also includes presence of small LDL₃ particles and increased concentration of apolipoprotein B. Determination of glycaemia and triglycerides and HDL-cholesterol levels is fundamental for the diagnosis of metabolic syndrome. The risk of the so-called "pre-analytical" error has to be minimized in order for the results of these investigations to be sufficiently...

Treatment of dyslipidemia in patients with metabolic syndrome and chronic kidney disease

V. Monhart

Vnitr Lek 2009, 55(7-8):671-678  

Dyslipidemia, often present in patients with metabolic syndrome and chronic kidney disease, contributes to increased cardiovascular risk and progression of renal impairment. In these patients, the probability of death from cardiovascular complications is higher than death consequent to terminal renal failure. Positive neuroprotective effects of statins and fibrates are being attributed to hypolipidemic as well as other, lipid-unrelated, properties. Statins are able to slow down the decline in glomerular filtration rate and may decrease proteinuria. Nevertheless, conclusive evidence that statins decrease the incidence of cardiovascular complications...

XXVIII. dny mladých internistů České republiky a Slovenska v Olomouci

P. Horák

Vnitr Lek 2009, 55(7-8):679