New clinical team approach reduced cardiovascular risk
Nearly 20 percent for obese metabolic syndrome patientsObesity researchers at the Medical College of Wisconsin in Milwaukee found that a multidisciplinary clinical approach to caring for obese patients with metabolic syndrome could swiftly and significantly lower their risk for heart disease.
The research found that such care could lower their ten-year risk for cardiovascular disease by nearly 20 percent within six months. It will be presented in a poster session, at the American Association of Clinical Endocrinologists Annual Meeting, in Chicago, April 28.
The study was conducted by Safak Guven, M.D., assistant professor of medicine at the Medical College and clinical director of the Obesity/Metabolic Syndrome Clinic at Froedtert Hospital, a major teaching affiliate of the Medical College, in collaboration with the University of Wisconsin School of Pharmacy.
"This study highlights the benefits of a clinic that specializes in the needs of obese patients with metabolic syndrome" says Dr. Guven. "Metabolic syndrome affects approximately 24 percent of the US adult population; according to the Third National Health and Nutrition Examination Survey criteria. About 47 million people have metabolic syndrome, including 44 percent of those who are ages 50 and older. Metabolic syndrome (without type 2 diabetes) significantly increases the risk of coronary heart disease (CHD).
The research could also help establish national clinical standards of care for metabolic syndrome, and accreditation for clinics treating this rapidly emerging problem. "Studies have shown that patients with metabolic syndrome are 1.5 times at greater risk for CHD," says Dr. Guven. "On the other hand, women in reproductive ages with metabolic syndrome are prone to have polycystic ovarian syndrome, which also puts them at risk for fertility issues. In other words, your waistline now has a significant impact on your lifeline."
Metabolic syndrome is a dangerous constellation of problems occurring in abdominally obese, insulin-resistant patients, with or without type 2 diabetes, and having any of several conditions, including cholesterol abnormalities, hypertension, clotting, or inflammatory protein factors in their blood. This leaves them extremely vulnerable to cardiovascular diseases caused by plaque deposits. These include coronary and/or peripheral artery disease and strokes.
The team reviewed charts of over 480 patients treated in the recently-developed obesity and metabolic syndrome clinic at Froedtert Hospital and found 46 obese patients who met the criteria for the study.
Outcomes data on these patients revealed that, after six months of treatment, their collective body mass index dropped 4.4 percent, their waist size 4.3 percent, their triglycerides (harmful fatty acids) dropped 13.1 percent and their HDL (beneficial) cholesterol level rose 6.2 percent. As a result, their ten-year risk of developing cardiovascular disease, based on scoring criteria established by the National Heart Lung and Blood Institutes' landmark Framingham Heart Study,* was reduced by 19.5 percent.
The metabolic syndrome clinic team includes an endocrinologist, dietitians, a psychologist, diabetes educators, clinical pharmacist, exercise physiologists and physical therapists. These patients also had access to bariatric surgery, sleep center, and obstetrics and gynecology fertility clinic for evaluations when appropriate. They were also eligible to participate in a support group, provided in collaboration with TOPS (Take off Pound Sensibly), a non-profit, non-commercial weight loss support group.
* Since 1948, this study has followed over 5,100 men and women from Framingham, Mass. and their descendants through the second and third generations, to identify the common factors or characteristics that contribute to cardiovascular disease.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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