This article is a segment of the series about the diseases associated with Metabolic Syndrome (MetS). Part 1 describes the top ten causes of deaths that are related to MetS.
Shortness of Breath
Metabolic Syndrome is associated with reduced lung function and higher chances of deaths from cardiovascular and all other causes. Difficulty breathing at rest and exertion are the main symptoms. A study published in PlosOne, Relationship between Lung Function and Metabolic Syndrome, determined that inhalation and exhalation in people with MetS are impaired. Noteworthy in the study is that the presence of just one component of the MetS (high blood sugar, dyslipidemia, hypertension, and obesity) is enough to cause a diminished lung function. The study, The Relationship between Metabolic Syndrome and Pulmonary Function, showed that the worse the MetS, the worse is the shortness of breath. For a detailed review of how the different components of the MetS affect breathing, this Chest article, Metabolic Syndrome and the Lung, is an excellent source.
Tuberculosis
Tuberculosis (TB) is prevalent in third world countries. There is a risk of a rise in the incidence of TB in developed countries because of migration. The significance of knowing the presence of both disease in one patient is to direct the treatment of TB and MetS, and diabetes. Some TB medications can cause more insulin resistance and worsen MetS. Likewise, diabetic medications can interact with TB treatment and lead to treatment failures and drug-resistant tuberculosis. For further, reading on this subject of drug interactions in TB and diabetes, this review, The Bidirectional Relationship between Tuberculosis and Diabetes, is helpful for the physicians and also to patients. TB was the number 10 cause of death in the world in 2016.
Asthma
Patients with asthma attacks are typical in the emergency room year round. Asthma, and metabolic syndrome: Current knowledge and future perspectives describe how hormonal imbalances early in life contributed to respiratory problems.
Asthma is also individually related to diabetes, insulin resistance, and obesity which are components of the MetS.
This review article, Metabolic syndrome, and asthma illustrate how young girls with severe asthma and MetS grow up to develop severe asthma symptoms. The mechanisms described were high cholesterol, lack of HDL and alteration in the immune system of the lungs because of the inflammatory proteins (cytokines) from visceral fat inside the abdomen.
Chronic Obstructive Lung Disease (COPD), Emphysema
Chronic Obstructive Pulmonary Disease (COPD) like emphysema and chronic bronchitis and the MetS pose a dual threat as it increases the risk for morbidity and mortality due to cardiovascular disease. Heart and lung problems usually go together and are characterized by chronic inflammation as described here Chronic obstructive pulmonary disease, and the metabolic syndrome: Consequences of a dual threat.
A study in Hippokratia, Metabolic syndrome in patients with chronic obstructive pulmonary disease: frequency and relationship with systemic inflammation., also found a higher level of systemic inflammation in those with COPD and MetS as evidenced by a higher white blood cell count and a higher C-reactive protein level compared to those with COPD without MetS.
PloS One published, Metabolic syndrome and Chronic Obstructive Pulmonary Disease (COPD): The interplay among smoking, insulin resistance, and vitamin D., and defines how smoking can potentially cause insulin resistance leading to diabetes and is connected both to MetS and COPD. COPD was the third leading cause of death in 2016. Lower respiratory infections are fourth. Anybody with COPD has a higher risk of complications and death when they have an acute condition like a heart attack or pneumonia.
Obstructive Sleep Apnea (OSA).
If you know somebody who snores loudly and then seems to stop breathing for several minutes then restarts again, they may have sleep apnea. If you feel sleepy during the daytime even if you think you had enough hours of sleep and you snore, you may need a sleep study. Why? Because sleep apnea may put you at risk for heart attacks and strokes. Just tell a life insurance agent that you have sleep apnea and watch your premium skyrocket. The article in Hippokratia, Metabolic syndrome, and sleep apnea describes the association between OSA and the MetS. Insulin resistance that develops with repeated insulin rise secondary to eating all day is common between OSA and MetS. Insulin resistance is the start of MetS. OSA leads to a decrease in oxygen levels in the blood and causes a dysfunction of the beta cells that produce insulin. In 1988 in Thorax, Wilcox et al. described the combination of vascular risk factors, heart disease, and sleep apnea and suggested it be called Syndrome Z.
This list is only cursory. The association between disease processes mentioned and MetS will be expanded in the future.
Take Away Messages
Avoiding or Reversing Metabolic Syndrome can help prevent TB, COPD, and Asthma
Treatment of TB, COPD, and asthma should include management of the metabolic syndrome.
A diagnosis of any disease related to the Metabolic Syndrome should prompt an investigation if you are at risk of developing ischemic heart disease. Talk to your doctor if there is a need to do a fasting blood sugar, serum triglyceride and HDL level, check your blood pressure and measure your waistline. Read The Metabolic Syndrome, and find out if you have MetS.
Part 3 talks about the relationship between Metabolic Syndrome Gout, Sleep Apnea, and Eye problems.
Image Credit:
Sleep Apnea: Habib M’henni Wikimedia Commons
Wikimedia Commons
Tuberculosis Research and Treatment
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