Recent changes in lifestyle such as high-fat diet and inactivity have promoted a metabolic disorder titled syndrome X. At the moment, it is very rare in Vietnam but the prevalence of this syndrome is going to significantly increases in next decades. In Endocrinology and Diabetic Dept- Bach Mai Hospital, we found a 44 year-old patient, who met the basic criteria of the syndrome X: Hypertension, central obesity and high fasting serum Insulin. He has mild dyslipidemia. All members of his family, including his mother and his sister are also suffering from syndrome X with hypertension, obesity and overt diabetes mellitus. This patient was advised to have diet with caloric restriction and exercise to improve insulin resistance. He has been using gemfibrozil (Lopid) and metformin. After 2 months, he has lost 6 kilograms and felt better. His blood pressure was controlled without antihypertensive drugs
Metabolic Syndrome X ; diagnosis

Humans ; Liver Diseases ; complications ; diagnosis ; Metabolic Syndrome ; complications ; diagnosis

Adolescent ; Child ; Humans ; Insulin Resistance ; Metabolic Syndrome ; diagnosis ; prevention & control

Syndrome differentiation is a methodology unique to Chinese medicine. It threads the diagnosis process with clinical treatment into a holistic web of links to determine and regulate the patterns of dysfunctions in the human body. It is seen as the essence of Chinese medicine because it takes into account the theoretical principles, diagnostic methodologies and the modality of treatment holistically. In this process the progressive development and changes of syndromes are also considered by the physician. This paper is a systematic study of the methodology of syndrome differentiation in relation to its clinical applications in the treatment of diseases. To illustrate the efficacy of syndrome differentiation, the relationship between pattern identification and diseases is analysed to provide a guiding principle for integration between Chinese medicine and Western medicine. Diseases being selected include cancer, cardiovascular and metabolic syndromes. A study of renal and hepatic diseases related to lifestyle is also included to highlight the clinical efficacy of syndrome differentiation. The paper also includes an analytical summary of the theoretical advancements made in integrative differentiation methodology during the past five decades which links to the recent clinical thinking and practice.
Diagnosis, Differential ; Humans ; Internal Medicine ; Medicine, Chinese Traditional ; methods ; Metabolic Syndrome ; diagnosis ; Syndrome

No abstract available.
Adenoma/*diagnosis ; Colorectal Neoplasms/*diagnosis ; Female ; Humans ; Male ; Metabolic Syndrome X/*diagnosis ; Uric Acid/*blood

OBJECTIVETo evaluate the relation between Pi-deficiency syndrome (PDS) pattern and metabolic syndrome (MS) in patients with polycystic ovarian syndrome (PCOS), for exploring their internal pathologic mechanism.

METHODSAmong the 102 PCOS patients, 22 complicated with MS (PCOS-MS) and 80 not complicated with MS (PCOS-NMS), the Chinese medicine syndrome pattern was differentiated as PDS in 50 patients and non-PDS in 52. The clinical data, in terms of fasting blood glucose (FBG), fasting insulin (FINS), waistline, body weight (BW), stature, blood pressure (BP), etc. was collected and compared and the relation between data was analyzed.

RESULTSLevels of FINS and homeostasis model of assessment for insulin resistence index (HOMA-IR), in PCOS-MS patients were significantly higher than those in PCOS-NMS patients, also higher in patients of PDS pattern than those of non-PDS pattern (P < 0.01); the occurrences of MS and PDS were highly positively correlated with levels of FINS and HOMA-IR (P < 0.01); incidence of MS in patients of PDS pattern was significantly higher than those in patients of non-PDS pattern (P < 0.05); presenting of PDS was positively related with the existence of MS (P < 0.05), but in case of the FINS or HOMA-IR factor being controlled, statistical meaning of the relativity between them turned to insignificant (P > 0.05).

CONCLUSIONSPCOS patients of PDS pattern are the high-risk population of MS, which might be related with the insulin resistance. So, early treatment of PCOS, especially on patients of PDS pattern, is of important significance for preventing the complication, as MS, of the disease.

Adult ; Diagnosis, Differential ; Female ; Humans ; Insulin Resistance ; Medicine, Chinese Traditional ; Metabolic Syndrome ; complications ; Polycystic Ovary Syndrome ; complications ; Yang Deficiency ; diagnosis

Adolescent ; Female ; Humans ; Insulin Resistance ; genetics ; Male ; Metabolic Syndrome ; complications ; diagnosis ; World Health Organization ; organization & administration

INTRODUCTIONTo review the definitions of the metabolic syndrome according to various expert groups and assess their relevance to clinical practice.

MATERIALS AND METHODSMedline searches were conducted to identify studies which addressed: (i) the utility of the metabolic syndrome compared to multivariable predictive functions for the identification of individuals at high risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), (ii) the importance and definition of obesity in the definition of the metabolic syndrome and (iii) the impact of lifestyle and pharmacological interventions designed to reduce the risk of cardiovascular disease in those with and without the metabolic syndrome.

RESULTSAlthough inferior to multivariable risk scores in predicting T2DM and CVD, the metabolic syndrome represents a simple clinical tool, particularly for the prediction of T2DM. Obesity is not a critical component of the metabolic syndrome for identifying those at increased risk of CVD but may be important for predicting T2DM. If anything, pharmacological therapy, especially lipid lowering is as, if not more, effective in those with the metabolic syndrome than in those without.

CONCLUSIONSAlthough the metabolic syndrome appears to have limited utility for the identification of individuals at increased risk of T2DM or CVD, the diagnosis of the metabolic syndrome presents an opportunity to rationalise health services to deliver coordinated care to those with metabolic syndrome.

Cardiovascular Diseases ; etiology ; Diabetes Mellitus, Type 2 ; etiology ; Humans ; Metabolic Syndrome ; complications ; diagnosis ; Obesity ; complications

OBJECTIVETo compare and evaluate clinical applications of two definitions of metabolic syndrome in children and adolescents, which was developed by Pediatric Academy of Chinese Medical Association in 2012 (Chinese definition) and by International Diabetes Federation in 2007 (IDF definition), respectively.

METHODS593 obese children and adolescents aged 10 ≊16 y from July 2006 to December 2012 were enrolled in the study. The diagnostic concordance of two definitions for metabolic syndrome and individual components was estimated, and their sensitivity and specificity for detecting insulin resistance and early macrovascular complications were compared.

RESULTSThe concordance between two definitions for diagnosing metabolic syndrome was good (kappa=0.626); as for detecting the individual components, the Kappa concordance index were 1.000, 0.803, 0.780, 0.734 and 0.594 for hypertriglyceridemia, hyperglycemia, cholesterol abnormality and hypertension, respectively. The incidence of insulin resistance and early macrovascular complications, detected by the two definitions, were both increased with increasing number of abnormal components. The sensitivity and specificity for detecting insulin resistance in children with metabolic syndrome were 54.5% and 65.7% by Chinese definition, and 36.1% and 83.1% by IDF definition; while the sensitivity and specificity for detecting early macrovascular complications were 58.3% and 55.8% by Chinese definition, and 37.3% and 70.8% by IDF definition. After adjusting for age and sex, compared to the obese children and adolescents without metabolic syndrome, the odds ratios of insulin resistance and early macrovascular complications were 2.166 (P<0.001) and 1.771(P=0.008) for children with metabolic syndrome diagnosed by Chinese definition, and the odds ratio of insulin resistance and early macrovascular complications were 2.618 (P<0.001) and 1.357 (P=0.190) by IDF definition.

CONCLUSIONThe concordance between Chinese and IDF definitions for diagnosing metabolic syndrome in Chinese obese children and adolescents is good. Compared to IDF definition, Chinese definition is more sensitive for hypertension, hyperglycemia and hypercholesterolemia, thus it can more effectively detect insulin resistance and early macrovascular complication.

Adolescent ; Child ; Female ; Humans ; Insulin Resistance ; Male ; Metabolic Syndrome ; classification ; complications ; diagnosis ; Obesity ; complications ; Sensitivity and Specificity

Adult ; Child ; Humans ; Metabolic Syndrome ; diagnosis ; etiology ; physiopathology ; Pediatrics ; trends ; Research ; trends