Metabolic Syndrome and Myocardial Infarction in Women

Abstract

Abstract: Metabolic syndrome (MetS) represents a cluster of metabolic disorders that arise from insulin resis-tance (IR) and adipose tissue dysfunction. As a consequence, there is an increased risk for type 2 diabetes melli-tus and atherosclerotic cardiovascular disease (CVD). MetS is associated with a 2-fold increase in cardiovascu-lar outcomes. Earlier population analyses showed a lower prevalence of MetS in women (23.9%) in comparisonto men (27.8%), while later analyses suggest significantly reduced difference due to an increase in the preva-lence in women aged between 20 and 39. However, the prevalence of MetS in specific populations of women,such as in women with polycystic ovary syndrome, ranges from 16% to almost 50% in some geographical re-gions. Abdominal fat accumulation and IR syndrome are recognized as the most important factors in the patho-genesis of MetS. After menopause, a decline in insulin sensitivity corresponds to an increase in fat mass, circu-lating fatty acids, low-density lipoproteins, and triglycerides. Prevalence of MetS in acute coronary syndrome(ACS) is significantly more present in women (55.9%-66.3%) than in men (40.2%-47.3%) in different cohorts.Younger women with ACS had a higher mortality rate than younger men. Acute myocardial infarction (AMI)remains a leading cause of death in aging women. Women with AMI had significantly higher rates of prior con-gestive heart failure, hypertension history, and diabetes. The role of androgens in CVD pathogenesis in womenhas not yet been clarified. The current review aims to provide an insight into the role of MetS components andinflammation for the development of atherosclerosis, CVD, and AMI in women.