By Lingjun Kong
Metabolic syndrome exhibits a complex, multifactorial etiology. Research comparing genetically different populations indicates that both genetics and lifestyle issues are major factors in its development. Approximately 20-30% of the middle-aged population in highly industrialized countries exhibits symptoms of metabolic syndrome. The symptoms of metabolic syndrome are multilayered. For example, a diagnosis of high blood pressure could also indicate high blood glucose, abnormal lipid levels, inflammatory disease, or obesity. Similarly, insulin resistance, urine proteins, heart disease, stroke, kidney failure, depression, and cancer could indicate metabolic syndrome as well. Among these symptoms, insulin resistance is considered to be the underlying factor in the mechanism of metabolic syndrome by the World Health Organization (WHO). Insulin resistance, denoted by hyperinsulinemia or the condition of excess circulating insulin in the blood, can lead to type 2 diabetes, which can result in macrovascular disease. The complications of diabetes are difficult to avoid for any diabetes patient. According to statistics from the American Diabetes Association (ADA) in 2010, the risk of complications for a diabetic patient of three years is over 46%, for a patient of five years is over 61%, and for a patient of over 10 years is 98%. Complications include kidney disease, system edema, headache, nausea, vomiting, oliguria, and the deadly uremia. Other conditions, such as mental illnesses, are indirectly associated with metabolic syndrome due to the increased likelihood of cardiovascular disease, obesity, and other metabolic syndrome criteria spurred by the condition or the consequent change in lifestyle.
Diabetes is no longer considered a western disease. It has spread around the world to become a significant global problem. The International Diabetes Federation estimates that by 2025 the number of diabetics will be 380 million, compared to 240 million in 2007. Over half the number of patients will be in Asia where the young and middle-aged will be the most affected age group, as compared to the elderly population in Europe and North America.
Health systems in Asia are battling an epidemic of obesity and diabetes that many are unable to handle. In countries such as India and China, urbanization and economic development have led to great shifts in the health risks of their related populations. Life expectancy has dramatically risen and infection rates have significantly dropped. However, a lifestyle transformation has also accompanied accelerated industrialization. Physical activity has decreased and the availability of food has increased; together, these two changes have resulted in increased rates of degenerative diseases such as diabetes and cardiovascular disease. The prevalence of diabetes in China has almost surpassed the 5.5% prevalence rate in Europe and North America, despite the rate being approximately 1% thirty years ago. Currently, there are approximately 92 million diabetics in China and 148 million pre-diabetic patients. Soon, China will overtake India as the world’s most diabetic country by sheer number. Together, the diabetic patients in China and India account for over half of the total diabetics in the world.
The Asian diet has transformed from one of primarily stir-fried, barbequed, and steamed vegetables and rice to one similar to the western diet of cereals and sugars, as well as vegetable oils and animal sources. Urbanization has tripled within the last half-century which corresponds with decreases in physical activity related to a rural lifestyle. The number of cars, which is associated with weight gain, has also risen with the development of cities. Moreover, the increase in general wealth has led to greater access to tobacco and alcohol, both of which can contribute to metabolic syndrome. The average number of cigarettes per capita went from one to 15 cigarettes within forty years; alcohol consumption quintupled in that same time.
In addition, with the improvement in quality of life, rates of overweight and obese children have risen. A new study shows the prevalence of metabolic syndrome among school children is 6.6% overall, and 33.1% in obese children. Childhood obesity rates correlate with high blood pressure, dyslipidemia, and especially, insulin resistance. In Asian Indian families with a history of type 2 diabetes in a firstdegree relative, a child with a high waistto- hip circumference ratio can have up to an 86.4% chance of developing type 2 diabetes.
Population-wise, Chinese women tend to have lower instances of cardiovascular problems, potentially due to the differing use of tobacco and alcohol within the culture’s social context. However, the culture may have developed and supported an overweight image within the wealthier class. This also correlates to the higher prevalence of metabolic syndrome in the highly urbanized regions of the country, specifically with the upper-class. Stress and other factors related with city life further contribute to this trend. Diabetes comes with a huge monetary cost as well. The WHO predicts that China alone will lose at least $558 billion in healthcare costs due to heart disease, stroke and diabetes over the next decade. Several medical organizations have been aware of the rising trend in metabolic syndrome in Asia for many years and have been searching for methods to reverse the change. They are establishing physical fitness programs, recommending doctors to emphasize the importance of eating right and being active, and also urging towns to grow their own food to avoid the influence of the western diet. Although implementation is difficult for countries of such severe infrastructure and healthcare, major steps have already been made. India, Pakistan and China are the top leaders of insulin manufacturers in the world, especially with the increased need of human, animal, and analogue insulin for their local markets. Wireless health monitoring and healthcare devices have become more technologically advanced and accurate. Most importantly, with more than half of the diabetes patients in the world residing in Asia now, science has strengthened the understanding of this complex disease – the first step in battling it.
Lingjun Kong, PMP Virtual Reality Medical Center U.S.A. email@example.com www.vrphobia.com
President of Virtual Reality Medical Institute (VRMI) in Brussels, Belgium. Executive VP Virtual Reality Medical Center (VRMC), based in San Diego and Los Angeles, California. CEO of Interactive Media Institute a 501c3 non-profit Clinical Instructor in Department of Psychiatry at UCSD Founder of CyberPsychology, CyberTherapy, & Social Networking Conference Visiting Professor at Catholic University Milan.