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:
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.