"Metabolic Syndrome, the Root Cause of Many Diseases, Predictable Through Various Indicators"

Gangnam Severance Family Medicine Professors Yongje Lee and Dahye Son Team

Professor Lee Yong-je (left) and Professor Son Da-hye, Department of Family Medicine, Gangnam Severance Hospital.

[Asia Economy Reporter Lee Gwan-joo] The range of biomarkers that can predict 'metabolic syndrome,' which increases the risk of cardiovascular and cerebrovascular diseases as well as diabetes, has expanded significantly.

The research team led by Professors Lee Yong-je and Son Da-hye from the Department of Family Medicine at Yonsei University Gangnam Severance Hospital announced on the 1st that they have published a review paper summarizing recent studies on new indicators of metabolic syndrome.

Metabolic syndrome refers to the simultaneous presence of various metabolic disorders in an individual, including abdominal obesity, increased blood triglycerides, decreased high-density lipoprotein cholesterol, hypertension, and impaired fasting glucose. If three or more of these five criteria fall outside the normal range, a diagnosis of metabolic syndrome is made. Most cases of metabolic syndrome are asymptomatic, but early detection and treatment are crucial as it increases the risk of cardiovascular diseases if it persists.

In this paper, the research team described several new potential biomarkers for metabolic syndrome alongside the well-known existing indicators, explaining their pathological mechanisms. Although the exact pathogenesis of metabolic syndrome has not yet been fully elucidated, insulin resistance and chronic inflammation are known to play major roles. Excessive fat accumulation in the body can disrupt insulin signaling pathways, leading to insulin resistance and elevated blood glucose levels. The accumulated adipose tissue itself secretes oxidative stress and inflammatory substances, which together induce atherosclerosis, hypertension, and insulin resistance.

Based on these mechanisms, the research team categorized the biomarkers of metabolic syndrome into ▲insulin resistance-related markers ▲inflammatory markers ▲adipokines (inflammatory substances secreted by adipose tissue) ▲oxidative stress markers ▲and other general chemical markers.

Various diagnostic criteria for metabolic syndrome. [Source=Gangnam Severance Hospital]

Insulin resistance markers commonly used include HOMA-IR (Homeostasis Model of Insulin Resistance), which is based on insulin and fasting glucose levels; the triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL); and the TyG index, which consists of triglycerides and fasting glucose. Among these, the TG/HDL ratio and TyG index are easy to calculate and are known to effectively reflect insulin resistance and metabolic syndrome, with their utility being demonstrated in many recent studies.

Among inflammatory markers, interleukin-6, tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and white blood cell counts have also been confirmed to be associated with metabolic syndrome. If these markers are elevated without the presence of diseases that can raise inflammation levels, such as infections, metabolic syndrome should be suspected.

Among adipokines, leptin, adiponectin, the adiponectin/leptin ratio, and plasminogen activator inhibitor-1 (PAI-1) have been identified as representative markers for metabolic syndrome. Leptin is a hormone secreted by fat cells that induces satiety and suppresses appetite, thereby regulating food intake. However, in patients with metabolic syndrome, the brain does not properly recognize leptin signals, resulting in increased leptin secretion but leading to obesity. Conversely, adiponectin is a hormone that enhances insulin sensitivity and prevents diabetes, and studies have shown that its levels are further decreased in individuals with metabolic syndrome.

Professor Lee Yong-je stated, "Metabolic syndrome is a rapidly increasing condition affecting one in three people nationwide, making early diagnosis and prevention paramount. Since this paper compiles the latest insights on various new potential biomarkers along with commonly used clinical markers, it is expected to aid in early diagnosis."

This paper was published in the international journal of clinical chemistry, Advances in Clinical Chemistry (IF: 6.303).

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