Friday, February 4, 2011

Metabolic Syndrome and Cognitive Function

Bordeaux, France - People with the metabolic syndrome were significantly more likely than others to experience a decline in cognitive function, independent of previous cardiovascular disease, depression, or APOE genotype, in a study of generally healthy adults aged 65 and older who were followed for four years [1]. In particular, hypertriglyceridemia and low HDL-cholesterol levels were associated with declines in global cognitive function, and diabetes was associated with deteriorating memory.
"Our study sheds new light on how metabolic syndrome and the individual factors of the disease may affect cognitive health," first author Dr Christelle Raffaitin (French National Institute of Health Research, Bordeaux, France) noted in a statement on the study from the American Academy of Neurology. The report was published online February 2, 2011 in Neurology.
"Our results suggest that management of metabolic syndrome may help slow down age-related memory loss or delay the onset of dementia." to read more click the link

http://www.theheart.org/article/1181423.do

My comments:

The data keeps coming in how detrimental the metabolic syndrome and insulin resistant cholesterol pattern is in terms of risk for disease beyond the heart. I feel it is very important to look for insulin resistance. The key is identifying it early and educating my patients of the risk to their health. This way a plan of action can be formulated.

Those markers of insulin resistance can include acanthosis nigricans on physical exam (unfortunately commonly seen in my practice in adults as well as in teens!), abnormal lab values like elevated uric acid, GGT, high TG/HDL ratio, elevated blood glucose, low testosterone, low vitamin D.

A word on blood glucose. I feel it is very important to make use of the 2 hour glucose tolerance test (fasting, 1 hour and 2 hour post 70 gram carbohydrate challenge). Based on this article in Diabetes care last March (http://care.diabetesjournals.org/content/33/3/557.full), a lot of information can be obtained and education points for patients. The scary realization from the study is that if the 1 hour blood glucose is over 150 mg/dl, you have a 13 times increased risk of becoming diabetic in the next 8 years (even with normal fasting and 2 hour blood glucose)! Worse yet, the risk starts to increase with the 1 hour sugar staring at 120 mg/dl!

So be on the look out and be vigilant, you never know when insulin resistance can rear it's ugly head. Unfortunately, these days it is more common than not.

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