MANILA, May 19, 2004 (STAR) By The Fame Health Bureau  -  This killer syndrome is on the loose, preying on millions of unsuspecting victims. Victim No. 1: Ricardo B., 54-year-old insurance manager, complained of no symptoms previously and could still play 18 holes of golf without using the golf cart; just slightly overweight; with borderline blood pressure (BP) and blood sugar (BS); low high-density lipoprotein or HDL (good cholesterol) and elevated triglycerides; rushed to the emergency room for an acute myocardial infarction (heart attack); and fortunately survived.

Victim No. 2: Elvira F., 59-year-old housewife; also without any previous symptoms; 30 lbs. overweight; with slightly elevated BP; normal fasting blood sugar but markedly elevated when checked two hours after eating a regular meal; low HDL; admitted to the hospital a few weeks ago for paralysis of the right half of the body, slurring of speech and inability to swallow food; still undergoing rehabilitation therapy and is fed through a tube (naso-gastric tube); feels depressed that she might have to be taken care of the rest of her life.

Victim No. 3: Lisandro M., 43-year-old entrepreneur; sedentary with hardly any exercise; grossly obese, hypertensive, diabetic; with elevated low density lipoprotein or LDL (bad cholesterol), low HDL and high triglycerides; suddenly collapsed while in a meeting in his office; was pronounced dead on arrival at the hospital ER.

These are just three of hundreds of sad stories of people who were unknowing victims of a killer syndrome which is fast developing into an epidemic in the Asian region. It is such a low-key, hardly publicized disease and many, including physicians, are not even aware that it exists. The majority of these patients may have no bothersome symptoms compelling enough for them to seek medical advice. In some instances, their first attack may be their last.

The National Cholesterol Education Program in the United States defined Syndrome X or metabolic syndrome as any three of the following: Abdominal obesity or people with an apple- shaped body where the waist is bigger than the hips, hypertension, diabetes mellitus, low good cholesterol or HDL (high density lipoprotein) and high triglycerides. People with Syndrome X are three times more at risk to develop cardiovascular disease and its complications compared to those without it.

According to Dr. John Foreyt, a professor at the Baylor College of Medicine in Houston, Texas, and one of the world-renowned authorities on the subject, insulin-resistance is a basic mechanism causing the adverse effects of Syndrome X. Insulin is the substance helping in the metabolism of sugar and carbohydrates ingested. Asians appear to have a relatively higher fasting sugar and elevated insulin levels, suggesting insulin resistance.

Increased insulin or hyperinsulinemia with resulting insulin resistance is reported to have an unfavorable effect on the cardiovascular system, specifically on the blood vessels, making people less flexible and more prone to progressive narrowing, known as atherosclerosis. People with Syndrome X are therefore at a higher risk of coronary heart disease and cardiovascular death.

Dr. Foreyt also highlighted the importance of a healthy lifestyle or behavioral changes in the management of Syndrome X. Diet and exercise are still important mainstays in treatment particularly in addressing obesity, which has been noted to be reaching epidemic proportions and is one of the risk factors of this killer syndrome.

In overweight individuals, as an adjunct to help many adults lose weight, there are safe fat blockers available on the market such as orlistat, popularly known as Xenical. There is a preponderance of scientific evidence published in reputable journals showing its efficacy and safety particularly in Syndrome X. Recently, the European Commission (EC) has also approved the use of orlistat in managing and reducing the risk for developing type 2 diabetes.

The landmark Xendos (Xenical in the prevention of diabetes in obese subjects) trial showed remarkable benefits in preventing diabetes and improving the overall cardiovascular risk. Results of the study showed that losing weight with orlistat reduced the risk of developing diabetes by 37 percent, compared with losing weight with lifestyle changes alone.

"Orlistat is the only fat blocker treatment that has been approved by the United States Food and Drug Administration for use in the management of obesity in adults and adolescents," said Dr. Foreyt.

Initially indicated for weight management, orlistat is now also indicated for the prevention and treatment of Syndrome X.

Reported by: Sol Jose Vanzi

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