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A síndrome metabólica: etiologia e tratamento
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Ao longo dos tempos, os padrões culturais e socioeconómicos sofreram diversas modificações. Os estilos de vida são cada vez menos saudáveis, prevalecendo o sedentarismo alinhado com dietas ricas em calorias e pobres em vitaminas e antioxidantes. O resultado é um aumento da prevalência de doenças não transmissíveis, incluindo a síndrome metabólica.
A síndrome metabólica reúne um conjunto de fatores de risco metabólicos interrelacionáveis, como a obesidade abdominal, hiperglicemia, hipertensão arterial e dislipidemia aterogénica que aumentam o risco de desenvolver doenças cardiovasculares, diabetes mellitus tipo 2, doenças hepáticas, doenças inflamatórias, doenças autoimunes e cancro. Sendo as doenças cardiovasculares a principal causa de morte em todo o mundo, é essencial evitar a progressão da síndrome de forma a reduzir a mortalidade.
A etiologia desta síndrome centra-se principalmente na obesidade abdominal, que contribui para resistência à insulina e para um estado de constante inflamação com consequências no metabolismo lipídico, glucídico e na pressão arterial.
As modificações dos estilos de vida são a primeira linha de tratamento. O objetivo principal do tratamento deve ser reduzir o excesso de peso. Recorrer a uma alimentação saudável e prática de exercício físico regular são assim essenciais para prevenir o aparecimento e desenvolvimento da síndrome metabólica. A dieta mediterrânica é uma boa solução, pela sua riqueza em vitaminas e antioxidantes, com o aumento da ingestão de frutas e vegetais, maior consumo de peixe e menor consumo de carnes vermelhas e gorduras saturadas. No entanto, outros regimes alimentares têm ganho bastante interesse, nomeadamente as dietas cetogénicas ou a alimentação com restrição de tempo. Quando as intervenções não farmacológicas são insuficientes na redução dos fatores de risco, é necessário recorrer ao tratamento farmacológico. Dado que não existe um tratamento único para esta doença, este é direcionado para as patologias associadas. Em virtude disso, a polifarmácia é uma realidade dos indivíduos com síndrome metabólica, resultando numa fraca adesão terapêutica e aumento de efeitos secundários indesejáveis.
Cultural and socio-economic patterns have changed over time. Lifestyles have become increasingly unhealthy, with a prevalence of sedentary lifestyles combined with diets high in calories and low in vitamins and antioxidants. The result is an increase in the prevalence of non-communicable diseases, including metabolic syndrome. Metabolic syndrome is a cluster of interrelated metabolic risk factors, such as abdominal obesity, hyperglycaemia, hypertension and atherogenic dyslipidaemia, which increase the risk of developing cardiovascular, liver, inflammatory, and autoimmune diseases, type 2 diabetes mellitus, and cancer. As cardiovascular diseases are the leading cause of death worldwide, preventing the progression of the syndrome is essential to reduce mortality. The etiology of the syndrome is mainly focused on abdominal obesity, which contributes to insulin resistance and a state of constant inflammation with consequences for lipid and glucose metabolism and blood pressure. Lifestyle modifications are the first line of treatment. The main goal of treatment should be to reduce excess weight. A healthy diet and regular exercise are essential to prevent the onset and development of metabolic syndrome. The Mediterranean diet is a good solution, as it is rich in vitamins and antioxidants, with an increased intake of fruit and vegetables, more fish and less red meat and saturated fats. Other diets, such as ketogenic diets or time-restricted eating, have recently gained a lot of interest. When non-pharmacological interventions fail to reduce risk factors, it is necessary to resort to pharmacological treatment. As there is no single treatment for this disease, it is targeted at the associated risk factors. Consequently, polypharmacy is a reality for people with metabolic syndrome, leading to poor adherence and an increase in adverse effects.
Cultural and socio-economic patterns have changed over time. Lifestyles have become increasingly unhealthy, with a prevalence of sedentary lifestyles combined with diets high in calories and low in vitamins and antioxidants. The result is an increase in the prevalence of non-communicable diseases, including metabolic syndrome. Metabolic syndrome is a cluster of interrelated metabolic risk factors, such as abdominal obesity, hyperglycaemia, hypertension and atherogenic dyslipidaemia, which increase the risk of developing cardiovascular, liver, inflammatory, and autoimmune diseases, type 2 diabetes mellitus, and cancer. As cardiovascular diseases are the leading cause of death worldwide, preventing the progression of the syndrome is essential to reduce mortality. The etiology of the syndrome is mainly focused on abdominal obesity, which contributes to insulin resistance and a state of constant inflammation with consequences for lipid and glucose metabolism and blood pressure. Lifestyle modifications are the first line of treatment. The main goal of treatment should be to reduce excess weight. A healthy diet and regular exercise are essential to prevent the onset and development of metabolic syndrome. The Mediterranean diet is a good solution, as it is rich in vitamins and antioxidants, with an increased intake of fruit and vegetables, more fish and less red meat and saturated fats. Other diets, such as ketogenic diets or time-restricted eating, have recently gained a lot of interest. When non-pharmacological interventions fail to reduce risk factors, it is necessary to resort to pharmacological treatment. As there is no single treatment for this disease, it is targeted at the associated risk factors. Consequently, polypharmacy is a reality for people with metabolic syndrome, leading to poor adherence and an increase in adverse effects.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2024, Universidade de Lisboa, Faculdade de Farmácia
Palavras-chave
Síndrome metabólica Inflamação Resistência à insulina Obesidade Dislipidemia Mestrado integrado - 2024