Importanţa tratamentului şi severităţii obezităţii în sindromul metabolic

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Article Title:	Importanţa tratamentului şi severităţii obezităţii în sindromul metabolic
Authors:	Lavinia Codruţa GLIGOR1, Şerban GLIGOR2
Affiliation:	1 Emergency Clinic Hospital, Timişoara, Romania 2 Western University, Timişoara, Romania
Abstract:	IMPORTANCE OF TREATMENT AND SEVERITY OF OBESITY IN METABOLIC SYNDROME. “American National Guide Cholesterol Education Program” – Panel III – identified metabolic syndrome as a constellation of clinical factors associated with an increased risk of type 2 diabetes and atherosclerotic cardiovascular disease developing. Metabolic syndrome is basically the result of complex interactions between several factors and genetic gain determinants, related to lifestyle. Metabolic syndrome treatment should vary, depending on the prevalence of its various components. Besides insulin resistance increasing importance is given in the last period to obesity. Pathogenesis of obesity consists in the fatty acids metabolism abnormalities, which adds an increase of de novo lipogenesis and a decrease of fatty acids oxidation. Abnormal metabolism and fatty acids lipotoxicity are linked to a number of metabolic syndrome components such as insulin resistance, diabetes type 2, dyslipidemia and nonalcoholic steatohepatitis. Although there is no clinical data indicating that the fatty acids metabolic pathways may be important for the treatment of obesity and metabolic syndrome, a number of enzymes involved in these pathways can be considered as therapeutic targets. Thus, inhibition of enzymes ACC1 and ACC2 (acetyl CoA carboxylases 1 and 2), may be useful in the treatment of obesity and hyperlipidemia. Medical treatment with pioglitazon and rosiglitazon reduces liver steatosis and achieves a reduction of hepatic insulin resistance. These drugs act as agonists of PPAR-γ receptor (a transcriptional factor in differentiating preadypocites in adypocites). Another treatment is with tiazolidindyone, which improves insulin resistance and hepatic steatosis, having a role in increasing subcutaneous fat and decreasing visceral fat. A possible treatment that may mitigate the metabolic syndrome symptoms and atherosclerosis is that with carbenoxolon, an inhibitor of the 11 β – hydroxisteroid dehydrogenase type 1 (11 β HSD1) enzyme.
Keywords:	treatment, severity, metabolic syndrome
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*Correspondence:	Lavinia Codruţa Gligor, Emergency Clinic Hospital, Timişoara, Romania, Email: medicina@uvvg.ro