Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- hipertensão
- aumento do índice de massa corporal (IMC)
- aumento das circunferências da cintura e do quadril
Other diagnostic factors
- hiperglicemia
- doença hepática gordurosa associada a disfunção metabólica (DHGDM)
- angina
- claudicação
- hiperuricemia
- distúrbios menstruais
- dor abdominal
- arco corneano e xantelasma
- hirsutismo
- acantose nigricans
- acne
- hepatomegalia
Risk factors
- obesidade
- resistência insulínica
- sedentarismo
- dieta rica em gordura saturada
- dieta com alto teor de carboidratos
- consumo excessivo de bebidas alcoólicas
- idade mais avançada
- etnia
- tabagismo
- história familiar positiva
- síndrome do ovário policístico (SOPC)
- hipogonadismo
- hipercortisolismo
- antipsicóticos
- distúrbios do sono
- lipodistrofia
- Infecção pelo vírus da imunodeficiência humana (HIV)
Diagnostic investigations
1st investigations to order
- glicemia de jejum
- triglicerídeos de jejum
- colesterol total de jejum
- colesterol de lipoproteína de alta densidade (HDL) de jejum
- colesterol de lipoproteína de baixa densidade (LDL) de jejum
Investigations to consider
- hemoglobina A1c (HbA1c)
- teste oral de tolerância à glicose (TOTG)
- ureia e creatinina séricas
- aminotransferases
- proporção creatinina/albumina na urina
- hormônio estimulante da tireoide (TSH)
- T4 livre
- ultrassonografia abdominal
- eletrocardiograma (ECG)
- testosterona sérica total e livre
- sulfato de prasterona sérico
- androstenediona
- globulina ligadora de hormônios sexuais sérica
- hormônio luteinizante e hormônio folículo-estimulante séricos
- prolactina
- ultrassonografia dos ovários
- ácido úrico sérico
- estradiol sérico
Treatment algorithm
todos os pacientes
Contributors
Authors
Panagiotis Anagnostis, MD, PhD
Endocrinologist
Department of Internal Medicine
Medical School
Aristotle University of Thessaloniki
Thessaloniki
Greece
Disclosures
PA declares that he has no competing interests.
Acknowledgements
Dr Panagiotis Anagnostis would like to gratefully acknowledge Professor Faidon Harsoulis, a previous contributor to this topic.
Disclosures
FH declared that he had no competing interests.
Peer reviewers
Cecilia C. Low Wang, MD, FACP
Professor of Medicine
University of Colorado Anschutz Medical Campus School of Medicine
Aurora
CO
Disclosures
CCLW declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009 Oct 20;120(16):1640-5.Full text Abstract
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec 17;106(25):3143-421.Full text Abstract
Cornier MA, Dabelea D, Hernandez TL, et al. The metabolic syndrome. Endocr Rev. 2008 Dec;29(7):777-822. Abstract
Grundy SM, Hansen B, Smith SC Jr, et al. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Circulation. 2004 Feb 3;109(4):551-6.Full text Abstract
Grundy SM, Brewer HB Jr, Cleeman JI, et al. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004 Jan 27;109(3):433-8.Full text Abstract
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019 Jun 18;139(25):e1082-143.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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