C 046: METABOLIC SYNDROME AND PLANT DRUGS

J Pharm Pharmacogn Res 2(Suppl. 1): S131, 2014

Special supplement with the abstract book of LATINFARMA 2013

Conference

C 046: METABOLIC SYNDROME AND PLANT DRUGS

Alonso J.

Asociación Argentina de Fitoterapia, Buenos Aires, Argentina.
Abstract

Insulin resistance, obesity, hypertension, and dyslipidemia are strongly associated with metabolic syndrome, which is considered to be a reversible clinical stage before its evolution to coronary heart disease and diabetes. Metabolic syndrome is also known as metabolic syndrome X, cardiometabolic syndrome, syndrome X, insulin resistance syndrome, etc. Is a combination of the medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. The term “metabolic syndrome” dates back to at least the late 1950s, but came into common usage in the late 1970s to describe various associations of risk factors with diabetes that had been noted as early as the 1920s. Kylin (1923) was a Swedish doctor who first defined the association between hypertension, gout and hyperglycemia.

Marseille Jean Vague, in 1947 and then in 1956, showed that people with obesity were predisposed to have in the future diabetes, atherosclerosis, thyroid dysfunction, and urinary calculations. In 1977, Haller employment for the first time the term “Metabolic Syndrome” in academic circles to refer an association between obesity, diabetes mellitus and fatty liver, describing in addition the risk factors for arteriosclerosis. Some studies have shown the prevalence in the USA to be an estimated 25% of the population, and prevalence increases with age.

The World Health Organization 1999 criteria require the presence of any one of diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance, and two of the following:

  • Blood pressure: ≥ 140/90 mmHg
  • Dyslipidemia: triglycerides (TG): ≥ 1.695 mmol/L and highdensity lipoprotein cholesterol (HDL-C) ≤ 0.9 mmol/L (male), ≤ 1.0 mmol/L (female)
  • Central obesity: waist: hip ratio > 0.90 (male); > 0.85 (female), or body mass index > 30 kg/m2
  • Microalbuminuria: urinary albumin excretion ratio ≥ 20 µg/min or albumin: creatinine ratio ≥ 30 mg/g.

Clasification

The European Group for the Study of Insulin Resistance (1999) requires insulin resistance defined as the top 25% of the fasting insulin values among nondiabetic individuals AND two or more of the following:

  • Central obesity: waist circumference ≥ 94 cm (male), ≥ 80 cm (female)
  • Dyslipidemia: TG ≥ 2.0 mmol/L and/or HDL-C < 1.0 mmol/L or treated for dyslipidemia
  • Hypertension: blood pressure ≥ 140/90 mmHg or antihypertensive medication
  • Fasting plasma glucose ≥ 6.1 mmol/L

In the Metabolic Syndrome there are furthermore hyperleptinemia and, at the same time, resistance to the own leptin. This substance is secreted in the adipocytes (mainly). When the amount of fat stored in the adipocytes increases, leptin is released into the bloodstream, to inform the hypothalamus that the body has a number of reservations and that should inhibit the appetite. Leptin also increases the oxidation of fatty acids and decreases the TGC in the adipocyte.

Diagnosis is based primarily on:

  • Clinic (abdominal measurement)
  • Blood analysis (lipid parameters and sugary)
  • Liver ultrasonography (confirm or rule out fatty liver)
  • Microalbuminuria (signal of endothelial dysfunction, kidney damage, disease CV)
  • ECG (Left Ventricular Hypertrohy)
  • Blood Pressure

Treatment

Increase physical activity, reduce weight, treatment of diabetes and insulin resistance, treat hyperlipidemia, hypertension, stress and anxiety disorders, and the fatty liver (if any). Many drugs used in these cases (glitazones, metformin, statins, orlistat, pharmaceuticals, etc) are not exempt from risks, and have not always yielded the expected results. In such a way that many plant drugs recently have been positioned to be able to give a finished therapeutic coverage and wide in each of the clinical manifestations of this syndrome, without generating the adverse effects so often observed.

At the conference will be published the scientific work and clinical experiences with extracts of artichoke (Cynara scolymus), african mango (Irvingia gabonensis), greater nettle (Urtica dioica), milk thistle (Silybum marianum), guava (Psidium guajava), noni (Morinda citrifolia), rooibus (Aspalathus linearis), spirulina (Spirulina pratensis), turmeric (Curcuma domestica), roselle (Hibiscus sabdariffa), resveratrol, coenzyme Q-10.