Obesity will be among the greatest influences on morbidity and mortality in the coming decades. A major contributor to obesity is "Metabolic Syndrome," defined by a combination of clinical and laboratory parameters, including:
- Central obesity (Increased waist-to-hip ratio due to excessive fat tissue in and around the abdomen)
- Raised blood pressure (130/85 mmHg or higher)
- Dyslipidemia (Mainly high triglycerides and low HDL)
- Insulin resistance (Hyperinsulinemia)
- Proinflammatory state (Elevated plasma AA/EPA ratio)
Metabolic Syndrome has widely replaced earlier references to "Syndrome X," although a more descriptive term might be Insulin Insensitivity Syndrome. The most direct cause of Metabolic Syndrome is declining responsiveness to insulin, leading to increased pancreatic insulin output to maintain normal blood glucose. The characteristic laboratory pattern is normal fasting serum glucose with elevated fasting insulin. Increased circulating insulin also stimulates the biosynthesis of fatty acids and cholesterol, raising serum levels of these lipids.
Elevated levels of the nitric oxide inhibitor ADMA (asymmetric dimethylarginine) is one of the most sensitive markers of insulin insensitivity. There is a clear relationship between the loss of insulin sensitivity and the rise of plasma ADMA levels. Dietary modifications of antioxidant vitamins and folic acid have been shown to successfully lower ADMA levels.
Balancing eicosanoid precursor fatty acids also helps to reverse metabolic syndrome. Any increase in inflammatory tendencies can exacerbate the effects of insulin insensitivity. When the plasma ratio of arachidonic acid (AA) to eicosapentaenoic acid (EPA) is high, the response of every tissue to inflammatory signals is exaggerated. This pro-inflammatory response tends to raise ADMA levels, propagating a vicious, feed-forward cycle. Such a cycle can be broken by fish oil supplements to raise EPA levels and lower the AA/EPA Ratio.
Factors contributing to Metabolic Syndrome are:
- Lifestyle, including high dietary carbohydrate (especially simple sugars) and physical inactivity that leads to low lean body mass
- Individual genetics
- Nitric oxide inhibition and eicosanoid imbalance leading to insulin insensitivity
The Metabolic Syndrome Profile:
- Detects insulin insensitivity and dyslipidemic sequelae
- Insulin
- Glucose
- HDL cholesterol
- Triglycerides
- Assesses underlying factors of nitric oxide and eicosanoid cell response regulators
- ADMA
- Arachidonic acid (AA)
- Eicosapentaenoic acid (EPA)
- AA/EPA ratio
- Guides interventions to restore and monitor metabolic function
Test name(s)
0146 - Metabolic Syndrome Profile*
Description
Metabolic Syndrome is characterized by a group of metabolic risk factors that include: central obesity, dyslipidemia, elevated blood pressure, insulin resistance or glucose intolerance, increased tendency to clot, and inflammation. The Metametrix Metabolic Syndrome Profile compiles several laboratory markers of the metabolic syndrome, allowing for a more comprehensive evaluation. The cutting-edge marker, ADMA, accentuates the innovative combination of analytes within this profile, allowing clinicians to have an unprecedented view into endothelial function.
Method
LC/MS-MS, GC/MS, Spectrophotometry, Chemiluminescence Assay
Turnaround time
8-12 days, 10 days average
Analytes
HDL Cholesterol
Triglycerides
Glucose
Insulin
ADMA (Asymmetric Dimethylarginine)
Arginine
Arachidonic acid (AA)
Eicosapentaenoic acid (EPA)
Ratios
AA/EPA Ratio
Arginine/ADMA Ratio
*Not available in New York
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