Метаболічний синдром в практиці сімейного лікаря

Abstract

Актуальною проблемою в усьому світі, зокрема в Україні, залишається рання діагностика метаболічного синдрому. Саме на підвищення настороженості сімейних лікарів, на усвідомлення ними всієї серйозності наслідків і ускладнень МС спрямована освітня робота. Для відображення реальної епідеміологічної ситуації в Україні з поширеності метаболічних захворювань з метою їх профілактики та своєчасної корекції, необхідно запровадити моніторинг метаболічного синдрому; Актуальной проблемой во всем мире, в частности в Украине, остается ранняя диагностика метаболического синдрома. Именно на повышение настороженности семейных врачей, на осознание ими всей серьезности последствий и осложнений МС направлена образовательная работа. Для отображения реальной эпидемиологической ситуации в Украине с распространенности метаболических заболеваний с целью их профилактики и своевременной коррекции, необходимо внедрить мониторинг метаболического синдрома; At the present metabolic syndrome (MS) is one of the most urgent problems of medicine. The prevalence of this disease, which is characterized by a combination of many risk factors for diabetes mellitus (DM) and cardiovascular disease, causes serious concern of the medical community. Today, researchers are studying the features of metabolic syndrome among different groups of population. Modern medicine provides a great opportunity concerning the correction of metabolic disorders if timely detection and efficient MS treatment algorithm are provided. The mentioned problem is worldwide and actual, particularly in Ukraine and the early diagnosis of it is real problem. So the educational work should provide first of all the increasing attention of practitioners, the awareness of the seriousness of the consequences and complications of MS. Metabolic syndrome is a condition of high risk of cardiovascular disease. In addition, the prevalence of metabolic syndrome is increasing year by year, taking the nature of the epidemic, and it occurs on average at every fifth adult in high developed countries . Frequency and terms of MS occurrence is different depending on ethnic, age data and criteria selected for identification, the accumulation of risk factors, stages of ontogeny, the degree of genetic predisposition, state compensation systems, the severity of environmental factors. This is due to neglect the healthy lifestyle, eating rich food contained the digestible carbohydrates, overeating, constant stress and sedentary lifestyle. An effective fight against MS is possible only on condition of deep understanding of the pathogenesis of this condition and development of pathogenetic approaches to drug therapy and prevention. MS develops gradually and long runs without obvious clinical symptoms. The presence of MS can be assumed even when external examination and patient history collection. Abdominal obesity (AO) is recognized by its characteristic redistribution of adipose tissue. Patients with a similar type of obesity often (70%) have the syndrome of obstructive sleep apnea (OSA), about which patients may be unaware. The patient may mark only the presence of snoring. When the patients` history are collected the detailed survey should be done to identify the patients` complaints on daytime sleepiness, the impaired concentration and anxious, choking episodes and / or stop breathing during sleep, loud cracked snoring, nocturia, irritability and personality changes, decreased libido, indentifying the events and / or risk of accidents (fact of dozens of short sleeps during driving). Particular attention should be paid to the fact of occurring complaints or stops of breathing during sleep. If the patient cannot answer this question, you must carefully ask relatives or friends of the patient . Clinic doctor may suspect the respiratory failure during sleep using a simple survey of the patient. The most common scale for evaluation of OSA symptoms is the Epworth Sleepiness Scale . If the patient suffers for AO you should clarify in detail the history of the disease, life, heredity and take the additional measurements. This can be important not only for the diagnosis of MS, prognosis, but also for determining the treatment. Most such patients are the majority of patients with hypertension and coronary heart disease, who refer to family doctors. So it is a family doctor who should refer the patients with cardiovascular disease and obesity research in lipid profile, determination of blood glucose and, if it is necessary to refer the patient to further consultation and treatment of a cardiologist and endocrinologist. It is not difficult to identify the patients with MS, the main thing is to be attentive and indifferent to patients, continuous analysis of their condition and possible complications of existing diseases. Underestimating MS leads to negative consequences. Treatment of MS effects is much more expensive in every respect than the early detection and treatment of metabolic disorders. To reflect the current epidemiological situation in Ukraine with the prevalence of metabolic diseases with the aim of prevention and early treatment should introduce monitoring of metabolic syndrome.