Evaluation and Consideration of Metabolic Syndrome, Associated Factors and Homocysteine Levels- A Cross-Sectional Study

Introduction: The metabolic syndrome is associated with prevalence and incidence of CHD, stroke. The Metabolic Syndrome is a modern-day epidemic which predicts total and cardiovascular diseases (CVD) mortality; the incidence and progression of carotid atherosclerosis and sudden death independent of other cardiovascular risks. Subjects with metabolic syndrome have three-fold risk of a heart attack or stroke, two-fold risk of CVD or dying from such events, and five-fold greater risk of developing type 2 diabetes mellitus in both sexes when compared to people without it. Day by day the incidences of metabolic syndrome, diabetes and cardiovascular disease increases in urban as well as rural areas, rich and poor communities because of life style changes, imbalance nutrition and easy availability of cheap fast food. India which is considered diabetic capital of world needed to be explored in direction of insulin resistance and metabolic syndrome and associated diseases. The relationship among insulin resistance, MetS, and cardiovascular (CV) morbidity and mortality has now been well established. Elevated plasma homocysteine, have been identified as a separate risk factor for hypertension and thus cardiovascular disease. Homocysteine aggravates hypertension by promoting vascular remodeling, oxidative stress, and endothelial dysfunction Materials and methods: We studied 50 healthy and 50 metabolic syndrome patients, with matched for age and. criteria fulfilling metabolic syndrome subjects taken as metabolic syndrome patients. selected from medical, paramedical staff and general public who were around 40 to 60 year of age. All subjects were belonged to the Latur district of Marathwada region. Patient belonging to group II were selected after attending medicine OPD of MIMSR Medical College, Latur detailed history, blood pressure, diabetes, dyslipidaemia, waist circumference etc. were taken and diagnosed as metabolic syndrome. Fasting blood sample were collected and blood glucose and lipid profile, homocysteine were determined. Results: In the control group I mean values of total cholesterol were 179.9 ± 22.60 mg %, serum triglycerides were 105.16  ± 22.53 mg %, and in the group II serum total cholesterol were 198.10 ± 25.56 mg %, triglycerides 181.1 ± 28.20 mg % and were significantly increased as compared to group I. The serum HDL-c in group II 39.14 ± 3.46 mg % were significantly decreased as compared to group I (45.92 ±3.48 mg %). Triglyceride /HDL-c ratio were significantly increased in group II as compared to group I. In the control group I homocysteine were 12.04 ± 3.5 μm/L and in the group II 19.41 ± 6.27 μm/L which were significantly increased as compare to group I. This difference is statistically significant (P < 0.0001) suggestive of strong association between homocysteine & metabolic syndrome. Conclusion: From the results of this study, we conclude that dyslipidemia is a common feature of metabolic syndrome, and a large number of patients had more than one individual lipid abnormality. Evaluation of lipid profile indicates that HDL-c is decreased and triglycerides, and VLDL-c are increased in metabolic syndrome patients. Increased ratio of triglycerides/HDL-c is a feature of metabolic syndrome, insulin resistance and a important predictor or marker of it. There was a strong association between homocysteine and metabolic syndrome.  Changed life style and dietary pattern are related factors in genesis of metabolic syndrome , elevated homocysteine and other metabolic abnormalities through insulin resistance and other mechanisms are  pointer to the need of routine screening of homocysteine  test in patients with metabolic syndrome . Routine screening for homocysteine in patients not only with metabolic syndrome but also in patients suffered from IHD OR MI and vice versa can be helpful in estimating the magnitude of overlap between two conditions, help in early detection and prompt intervention of any of the two conditions, so as to design the holistic strategies of management And also to prevent end organ damage at other places of arteries.