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Australian Journal of Pharmacy : October 2005
pharmacy pro pharmacy professional updates Weight-related metabolic syndrome affects one in three Australian adults HE increasing prevalence of Meta- bolic Syndrome could possibly reverse the gains made through the recent decline in cardiovascular (CVD) mortality, according to an editorial in a recent edition of the Medical Journal of Australia (2005; 183 (4): 175–176). In addition, international experts agreed for the first time that central obe- sity, or fat around the middle, is the main predictor for Metabolic Syndrome, a clus- ter of conditions that includes: raised blood pressure, raised serum triglyceride level, reduced serum HDL-cholesterol level, impaired fasting glycaemia and/or type 2 diabetes. T According to co-author of the new International Diabetes Institute definition of metabolic syndrome, Professor Paul Zimmet: ‘While there has been much dis- cussion about metabolic syndrome in the medical community in recent times, this new definition will for the first time, pro- vide Australian healthcare professionals with a set of clearly identifiable criteria that will assist them in identifying and treating sufferers of this potentially life threatening condition.’ Using the new definition (see box), Pro- fessor Zimmet has analysed AusDiab data indicating one in three Australian adults have metabolic syndrome. ‘It’s alarming that so many Australians have metabolic syndrome, particularly given people with the condition are five times more likely to get type 2 diabetes and two times more likely to die of CVD. said Professor Zimmet. ‘People with metabolic syndrome are not necessarily obese, so people who may regard themselves as only slightly over- weight who could actually be at equal— or even higher— risk than those consid- ered obese, and should be encouraged to see a doctor,’ said Professor Zimmet. ‘While intervention programs, includ- ing advice on diet and exercise, may help some people lose weight and reduce their risk factors, there is a group, perhaps 50 per cent of sufferers, who don’t respond to those measures and may require drug therapies,’ said Professor Zimmet. Definition T HE International Diabetes Federation has defined Metabolic Syndrome as patients with: Central obesity defined as waist circumference: Europid men =94cm , women =80cm, South Asian and South-East Asian men =90cm, women =80cm; Japanese men =85cm, women =90cm). Plus two of the following: • Raised serum triglyceride level: =1.7mmol/L. • Reduced serum HDL cholesterol: <1.03 mmol/L in males and <1.29mmol/L in females. • Raised blood pressure: systolic blood pressure =130mmHg or diastolic blood pressure =85mmHg, or treatment of previously diagnosed hypertension. ¦ • Impaired fasting glycaemia: fasting plasma glucose (FPG) =5.6mmol/L, or previously diagnosed type 2 diabetes. EOPLE with hepatitis C, particu- larly those from Asian backgrounds, are encouraged to participate in Aus- tralia’s largest clinical study of hepatitis C among South-East Asian populations. The South East Asian Study of Novel Hepatitis C Genotypes (SEASON) will explore differences in cure rates between South-East Asian and Caucasian popula- tions on an individualised program of anti-viral therapy. Recruitment for SEASON has been announced in eight centres in Sydney, Melbourne, Brisbane and Perth, with Australian hepatitis C study to examine cure rates among South-East Asians P investigators aiming to complete 400 patients on a treatment program. The study is made possible by a $4m contribution from Schering-Plough. Monash University hepatologist and SEASON chief investigator, Professor William Sievert, believes the study will have major implications for the treatment of the disease both in Australia and glob- ally. ‘Australians from South-East Asian backgrounds who have hepatitis C may have strains of the virus that are more likely to respond to anti-viral therapy than 794 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL 86 OCTOBER 2005 those found in the Caucasian population,’ he said. ‘SEASON will build on several small recent studies into cure rates with stan- dard anti-viral therapy among people infected with the unique strains of the virus found in South East Asia. An estimated 242,000 Australians have been exposed to the hepatitis C virus, with 182,000 of these patients progressing to chronic infection of the liver. Further information about the SEASON clinical trial is available by calling 1800 800 838. ¦