BOOK
The Metabolic Syndrome at the Beginning of the XXI Century
Jose A. Gutiérrez Fuentes | Manuel Serrano Ríos
(2005)
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Book Details
Abstract
- El síndrome metabólico es uno de los retos más intrigantes y fascinantes de la medicina contemporánea. Se trata de una patología en la que confluyen problemas de distintas áreas de la medicina: diferentes grados de hipertensión, acumulación de grasa, insulinoresistencia, estados protrombótico y proinflamatorio, todos juntos en la misma persona. Esta concurrencia de factores hace que la persona tenga un riesgo mucho mayor de sufrir enfermedad cardiovascular o diabetes mellitus tipo 2, que lo que la suma de los factores individuales supondría.
- Se trata de una "enfermedad" nueva, que ha llegado a ser un problema de salud pública muy importante en las sociedades desarrolladas y cuya rápida extensión se debe fundamentalmente a la adopción del estilo de vida occidental: fundamentalmente, muy poca actividad física e ingesta excesiva de alimentos.
- Esta obra trata el concepto del Síndrome metabólico en su más amplio sentido y da respuesta a la multitud de incógnitas que todavía presenta esta patología. Con un enfoque multidisciplinar y un equipo de colaboradores internacionales (España, Italia, Japón, Alemania, Estados Unidos, Reino Unido, Finlandia, Australia, etc.) de primer nivel en las distintas áreas, escrita íntegramente en inglés, revisa todos los aspectos relacionados con el Síndrome metabólico, desde el punto de vista de la fisiopatología molecular y la epidemiología genética: obesidad, insulinoresistencia, dislipidemias, hipertensión, enfermedad cardiovascular y otros nuevos como inflamación molecular, estado protrombótico, disfunción endotelial...
- Todos los capítulos presentan un abstract, en inglés y castellano, al inicio de cada capítulo con los puntos fundamentales que se van a desarrollar en ese capítulo.
- Esta obra trata el concepto del síndrome metabólico en su más amplio sentido y da respuesta a la multitud de incógnitas que todavía presenta esta patología.
- Se trata de una "enfermedad" nueva, que ha llegado a ser un problema de salud pública muy importante en las sociedades desarrolladas y cuya rápida extensión se debe fundamentalmente a la adopción del estilo de vida occidental.
- Todos los capítulos presentan un abstract, en inglés y castellano, al inicio de cada capítulo, con los puntos fundamentales que se van a desarrollar en ese capítulo.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Copyright Page | ii | ||
| List of Authors | iii | ||
| Introduction | 1 | ||
| Capítulo 1. Origin and Development of the Metabolic Syndrome | 5 | ||
| Summary | 6 | ||
| Resumen | 6 | ||
| Introduction | 6 | ||
| Historical development of the Metabolic Syndrome concept | 7 | ||
| Pathophysiological issues | 8 | ||
| ATP III Diagnostic criteria | 10 | ||
| Main research challenges | 11 | ||
| References | 12 | ||
| Capítulo 2. Intracellular Signaling Mechanisms Involved in Insulin Action | 15 | ||
| Summary | 16 | ||
| Resumen | 16 | ||
| Overview of insulin action | 16 | ||
| GLUT4 glucose transporters | 17 | ||
| Insulin stimulates GLUT4 trafficking | 20 | ||
| Insulin signaling pathways | 22 | ||
| Insulin mimetics | 31 | ||
| Acknowledgments | 33 | ||
| References | 33 | ||
| Capítulo 3. Cellular Models for the Study of Type 2 Diabetes | 43 | ||
| Summary | 44 | ||
| Resumen | 44 | ||
| Introduction | 44 | ||
| Uncoupling insulin signaling cascade: insulin resistance is tissue specific | 45 | ||
| Genetic cellular models for the study of insulin resistance and sensitivity | 46 | ||
| Models of insulin resistance associated with obesity | 53 | ||
| Acknowledgments | 59 | ||
| References | 59 | ||
| Capítulo 4. Transgenic Animal Models and the Metabolic Syndrome | 67 | ||
| Summary | 68 | ||
| Resumen | 68 | ||
| Introduction | 68 | ||
| Alterations of white and brown adipose tissue function and the Metabolic Syndrome | 69 | ||
| A primary alteration in liver may lead to whole-body metabolic alterations | 73 | ||
| Skeletal muscle alterations in the Metabolic Syndrome | 75 | ||
| Conclusion | 77 | ||
| Acknowledgments | 77 | ||
| References | 77 | ||
| Capítulo 5. Aging and the Metabolic Syndrome | 83 | ||
| Summary | 84 | ||
| Resumen | 84 | ||
| Introduction: Biology of aging and aspects related to Metabolic Syndrome | 85 | ||
| Relationship of Metabolic Syndrome (MetS) and specific manifestations with age | 87 | ||
| Insulin resistance due or related to aging? | 90 | ||
| Interactive conclusions for Metabolic Syndrome and aging | 92 | ||
| References | 95 | ||
| Capítulo 6. Gene/Environment Interaction: Thrifty Genotype Versus Thrifty Phenotype | 101 | ||
| Summary | 102 | ||
| Resumen | 102 | ||
| The thrifty genotype hypothesis | 102 | ||
| The thrifty phenotype hypothesis | 103 | ||
| Alternative hypotheses | 103 | ||
| Diet in an evolutionary perspective | 103 | ||
| A synthesis of theories | 104 | ||
| Interaction between fetal programming and lifestyle | 104 | ||
| Lessons from Asia | 104 | ||
| Loss of physiological flexibility of metabolism | 105 | ||
| Nutrition, reproduction and longevity | 105 | ||
| Further perspectives based on evolutionary biology | 106 | ||
| The role of caloric restriction and aging | 106 | ||
| Conclusions and future perspectives | 107 | ||
| References | 107 | ||
| Capítulo 7. Epidemiology of the Metabolic Syndrome | 109 | ||
| Summary | 110 | ||
| Resumen | 110 | ||
| Scope of the problem | 110 | ||
| Definitions of the Metabolic Syndrome | 111 | ||
| The Metabolic Syndrome: a controversial concept | 111 | ||
| Who is at risk? | 113 | ||
| Geographical distribution | 120 | ||
| Secular trends | 121 | ||
| Metabolic Syndrome in children and adolescents | 121 | ||
| The future of the Metabolic Syndrome | 123 | ||
| References | 123 | ||
| Capítulo 8. Genetic Susceptibility to the Metabolic Syndrome | 133 | ||
| Summary | 134 | ||
| Resumen | 134 | ||
| Introduction | 134 | ||
| Heritability of the components of the Metabolic Syndrome | 135 | ||
| Thrifty genotype or phenotype | 135 | ||
| Search for genes for the Metabolic Syndrome | 136 | ||
| Candidate genes for the Metabolic Syndrome | 137 | ||
| Genome wide scans | 141 | ||
| Conclusions | 142 | ||
| References | 142 | ||
| Capítulo 9. Genomic of Skeletal Muscle and its Implications in the Metabolic Syndrome | 153 | ||
| Summary | 154 | ||
| Resumen | 154 | ||
| Introduction | 154 | ||
| A “transcriptomic strategy” to find genes for the insulin resistance syndrome | 155 | ||
| A “proteomic strategy” to find genes for the insulin resistance syndrome | 158 | ||
| A mitochondrial hypothesis for the insulin resistance syndrome? | 159 | ||
| Conclusions | 159 | ||
| References | 159 | ||
| Capítulo 10. The Metabolic Syndrome: Obesity and Diet Modulates the Expression of its Genetic Predisposition | 163 | ||
| Summary | 164 | ||
| Resumen | 164 | ||
| Genes and cardiovascular risk | 164 | ||
| The Metabolic Syndrome: components, prevalence and therapies | 165 | ||
| Multiple candidate genes and environmental factors driving the Metabolic Syndrome | 166 | ||
| Modulators of the association between genotypes and phenotypes in the Metabolic Syndrome | 169 | ||
| Conclusions | 172 | ||
| Acknowledgments | 172 | ||
| References | 172 | ||
| Capítulo 11. Pathophysiology of Insulin Action in Humans | 179 | ||
| Summary | 180 | ||
| Resumen | 180 | ||
| Introduction | 180 | ||
| Pathophysiology of insulin-mediated glucose metabolism | 182 | ||
| The role of the adipose tissue in the pathophysiology of insulin action | 186 | ||
| Insulin action is not limited to glucose – FFA metabolism. The pleiotropic action of insulin | 188 | ||
| Insulin action on the b-cell. Another insulin–resistant tissue? | 190 | ||
| A tentative description of integrated pathophysiology of insulin action in man | 190 | ||
| References | 191 | ||
| Capítulo 12. Leptin, Insulin and Blood-Brain Barrier Relations in Obesity | 199 | ||
| Summary | 200 | ||
| Resumen | 200 | ||
| A short overview of the BBB | 200 | ||
| The BBB in dysfunction and disease | 201 | ||
| Transport of feeding-related peptides and proteins across the BBB | 203 | ||
| Leptin and insulin resistance syndromes | 207 | ||
| Conclusions | 209 | ||
| References | 209 | ||
| Capítulo 13. Chronic Inflammatory Hypothesis in the Metabolic Syndrome | 217 | ||
| Summary | 218 | ||
| Resumen | 218 | ||
| Introduction | 218 | ||
| Effector arm of the innate immunity and the Metabolic Syndrome | 219 | ||
| Sensing arm of the innate immunity and the Metabolic Syndrome | 223 | ||
| The hypothesis of inflammation: More than a hypothesis? | 226 | ||
| References | 227 | ||
| Capítulo 14. Metabolic Syndrome and Adipokines | 233 | ||
| Summary | 234 | ||
| Resumen | 234 | ||
| Introduction | 235 | ||
| Identification and structure of adiponectin | 235 | ||
| Insulin resistance and adiponectin | 237 | ||
| Action mechanism of adiponectin | 239 | ||
| Alterations in adiponectin gene are associated with diabetes | 241 | ||
| Cloning of adiponectin receptors | 243 | ||
| Regulation of adiponectin receptors | 244 | ||
| The adiponectin hypothesis | 245 | ||
| Adiponectin and adiponectin receptors as therapeutic targets | 245 | ||
| Acknowledgments | 246 | ||
| References | 247 | ||
| Capítulo 15. Role of PPARs in the Pathogenesis of the Metabolic Syndrome | 253 | ||
| Summary | 254 | ||
| Resumen | 254 | ||
| The Metabolic Syndrome from an adipose tissue perspective | 254 | ||
| PPARs and the Metabolic Syndrome | 255 | ||
| Obesity, the driving factor in the Metabolic Syndrome? | 257 | ||
| Insulin resistance, the common link in the Metabolic Syndrome | 259 | ||
| PPARs and dyslipidemia | 262 | ||
| PPARs in atherosclerosis and inflammation | 263 | ||
| Hypertension | 264 | ||
| Conclusions | 265 | ||
| References | 266 | ||
| Capítulo 16. The Lipotoxicity and Glucotoxicity Hypothesis in the Metabolic Syndrome and Type 2 Diabetes | 271 | ||
| Summary | 272 | ||
| Resumen | 272 | ||
| Introduction | 272 | ||
| Lipotoxicity | 272 | ||
| Consequences of lipid accumulation | 274 | ||
| Insulin secretion | 276 | ||
| Glucotoxicity | 276 | ||
| Conclusions | 278 | ||
| References | 279 | ||
| Capítulo 17. Thermogenesis and the Metabolic Syndrome | 283 | ||
| Summary | 284 | ||
| Resumen | 284 | ||
| Introduction | 284 | ||
| Components of energy expenditure | 285 | ||
| The contribution of reduced thermogenesis to obesity and its metabolic complications | 288 | ||
| Reduced oxidative capacity as a risk factor for the Metabolic Syndrome, and in particular for the development of muscle insulin resistance | 291 | ||
| UCP2 and pancreatic b cell function | 291 | ||
| Thermogenic effects of leptin and insulin and the interrelationship between the two hormones | 293 | ||
| Strategies and targets for intervention | 296 | ||
| References | 297 | ||
| Capítulo 18. Nitric Oxide and Cell Metabolism Dysfunction in the Metabolic Syndrome | 305 | ||
| Summary | 306 | ||
| Resumen | 306 | ||
| Introduction | 306 | ||
| Oxidative metabolism in humans with Metabolic Syndrome | 307 | ||
| Defective oxidative metabolism in visceral fat of patients with Metabolic Syndrome? | 307 | ||
| eNOS–/– mice: a model of Metabolic Syndrome that suggests a novel pathophysiological process | 308 | ||
| Mitochondrial biogenesis | 310 | ||
| Transcriptional control of mitochondrial biogenesis | 311 | ||
| NO as a regulator of mitochondrial functions | 312 | ||
| NO and mitochondrial biogenesis: signaling system sensors of metabolic state of the cell | 312 | ||
| Conclusions | 313 | ||
| Acknowledgments | 314 | ||
| References | 314 | ||
| Capítulo 19. Endothelial Dysfunction in the Metabolic Syndrome | 321 | ||
| Summary | 322 | ||
| Resumen | 322 | ||
| Introduction | 322 | ||
| General model of nitric oxide production | 323 | ||
| The endothelium beyond NO | 324 | ||
| Assessment of endothelial function | 325 | ||
| Mechanistic insight into endothelial dysfunction by risk factors included in the MetS | 326 | ||
| Inflammation | 328 | ||
| Endothelial dysfunction in the MetS | 329 | ||
| The effect of high blood pressure | 330 | ||
| The effect of dyslipidemia | 331 | ||
| The effect of visceral obesity | 333 | ||
| Conclusions | 334 | ||
| References | 334 | ||
| Capítulo 20. Hypertension in the Metabolic Syndrome | 339 | ||
| Summary | 340 | ||
| Resumen | 340 | ||
| A bit of history | 340 | ||
| The place of hypertension in the conflict of MetS definitions | 341 | ||
| Genes vs. environment | 341 | ||
| Pathophysiology | 342 | ||
| The problem of “metabolically correct” antihypertensives | 344 | ||
| References | 345 | ||
| Capítulo 21. Dyslipidemia in the Metabolic Syndrome | 347 | ||
| Summary | 348 | ||
| Resumen | 348 | ||
| The lipid triad | 349 | ||
| Dyslipidemia profile in the Metabolic Syndrome | 350 | ||
| Pathophysiology of metabolism of triglyceride rich lipoproteins (TRLs) | 351 | ||
| Dyslipidemia in the Metabolic Syndrome primarily a postprandial phenomenon? | 352 | ||
| Dyslipidemia and insulin resistance in the Metabolic Syndrome | 354 | ||
| Dyslipidemia and vascular disease in the Metabolic Syndrome | 354 | ||
| References | 356 | ||
| Capítulo 22. Alterations in Thrombosis and Fibrinolysis in the Metabolic Syndrome | 359 | ||
| Summary | 360 | ||
| Resumen | 360 | ||
| Introduction | 360 | ||
| Mechanism of endothelial dysfunction | 362 | ||
| Upregulation of coagulation | 364 | ||
| Vulnerable blood | 364 | ||
| Thrombin as a link between inflammation and coagulation | 365 | ||
| Therapeutic Insights and Concluding Remarks | 366 | ||
| References | 366 | ||
| Capítulo 23. Insulin Resistance and Coronary Heart Disease | 369 | ||
| Summary | 370 | ||
| Resumen | 370 | ||
| Introduction | 370 | ||
| Evaluation of direct and indirect effects of hyperinsulinemia / insulin resistance on the risk of CHD | 370 | ||
| Associations of insulin resistance / hyperinsulinemia with cardiovascular risk factors | 371 | ||
| Hyperinsulinemia, insulin resistance and CHD: prospective studies | 374 | ||
| Direct effects of hyperinsulinemia and insulin resistance on the risk of CHD | 378 | ||
| Conclusions | 379 | ||
| References | 379 | ||
| Capítulo 24. Nonalcoholic Fatty Liver Disease: A new entry in the Metabolic Syndrome? | 383 | ||
| Summary | 384 | ||
| Resumen | 384 | ||
| Introduction | 384 | ||
| Link between NAFLD and features of the Metabolic Syndrome | 384 | ||
| Pathomechanism of NAFLD | 385 | ||
| Early screening tools to detect subjects at risk for NAFLD and/or the Metabolic Syndrome | 387 | ||
| Predictors of high liver fat content | 388 | ||
| Conclusions | 389 | ||
| References | 389 | ||
| Capítulo 25. Hyperinsulinism, Insulin Resistance and Fertility | 393 | ||
| Summary | 394 | ||
| Resumen | 394 | ||
| Introduction | 394 | ||
| Insulin and IGF system in the reproductive organs | 395 | ||
| The “HAIR-AN” syndrome | 397 | ||
| Other IR syndromes with hyperandrogenism | 398 | ||
| IR and polycystic ovarian syndrome (PCOS) | 398 | ||
| Conclusions | 405 | ||
| References | 405 | ||
| Capítulo 26. Nutritional Treatment in the Metabolic Syndrome | 415 | ||
| Summary | 416 | ||
| Resumen | 416 | ||
| Introduction | 417 | ||
| Role of carbohydrates in insulin resistance | 417 | ||
| Fat and insulin resistance | 422 | ||
| Dietary recommendations for the Metabolic Syndrome | 422 | ||
| Changes in lifestyle vs. drug treatment | 426 | ||
| References | 426 | ||
| Capítulo 27. Drug Treatment in the Metabolic Syndrome | 431 | ||
| Summary | 432 | ||
| Resumen | 432 | ||
| Etiology | 432 | ||
| Environmental factors | 433 | ||
| Pathogenesis | 438 | ||
| Pathogenic pathways and drug targets | 445 | ||
| Current therapeutics | 450 | ||
| Perspective | 453 | ||
| References | 454 | ||
| Capítulo 28. The Metabolic Syndrome: Lifestyle, Drugs, or Both? | 463 | ||
| Summary | 464 | ||
| Resumen | 464 | ||
| Introduction | 464 | ||
| Lifestyle interventions | 465 | ||
| Implementing dietary change to prevent the Metabolic Syndrome | 468 | ||
| Social factors in prevention | 469 | ||
| Physical activity and inactivity | 470 | ||
| Pharmacotherapy: Preventing diabetes and cardiovascular disease | 470 | ||
| Conclusions | 471 | ||
| References | 472 | ||
| Index | 475 |