Question

Research and consider three conditions, through the process of differential diagnosis that would present with varying abnormalities in homeostatis, metabolism, triglycerides, and DNA respectively as outlined here( Homeostatic: Insulin resistance, Metabolic: Cardiometabolic dysfunction., Triglycerides: Abdominal obesity, High plasmatriglycerides(TG)/Low plasma High-density lipoprotein(HDL), DNA: Decreased tolomere length ) In the written presentation response (3 paragraphs) Include the following: Identify and explain your process of differential diagnosis and why you believe your three choosen conditions appropriately fir the above parameters as a potential diagnosis. Make certain to identify your primary diagnostic choice out of the three presented. Fully identify the sources used in your research.

Answer 1

The three conditions are:-

1. Metabolic Syndrome

2. Diabetes Mellitus Type II

3. Morbid Obesity

All three conditions have Insulin resistance, cardiometabolic dysfunction , abdominal obesity, high plasma triglycerides(TG)/Low plasma High-density lipoprotein(HDL) ,and decreased tolomere length .Telomere shortening has been shown to accompany physical disease states that are associated with aging and stress exposure, including diabetes mellitus, obesity, heart disease, chronic obstructive pulmonary disease (COPD), asthma, as well as psychiatric illnesses, such as depression, anxiety, post traumatic stress disorder (PTSD), bipolar disorder, and schizophrenia.Furthermore, some studies have demonstrated relationships between the stress response system, oxidative stress, and telomere shortening in these diseases.⁴

Metabolic syndrome is a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels .Metabolic syndrome increase the chance of developing heart disease, stroke, and diabetes..The condition is also known by other names including Syndrome X, insulin resistance syndrome, and dysmetabolic syndrome. According to a national health survey, more than 1 in 5 Americans has metabolic syndrome. The number of people with metabolic syndrome increases with age, affecting more than 40% of people in their 60s and 70s.

People that are at risk of developing Metabolic Syndrome are

• People with central obesity (increased fat in the abdomen/waist).
• People with diabetes mellitus or a strong family history of diabetes mellitus.
• People with other clinical features of "insulin resistance" including skin changes of acanthosis nigricans ("darkened skin" on the back of the neck or underarms) or skin tags (usually on the neck).

  Consistently high levels of insulin and glucose are linked to many harmful changes to the body, including:

• Damage to the lining of coronary and other arteries, a key step toward the development of heart disease or stroke.
• Changes in the kidneys' ability to remove salt, leading to high blood pressure, heart disease and stroke.
• An increase in triglyceride levels, resulting in an increased risk of developing cardiovascular disease.
• An increased risk of blood clot formation, which can block arteries and cause heart attacks and strokes.

A slowing of insulin production, which can signal the start of type 2 diabetes, a disease that is in itself associated with an increased risk for a heart attack or stroke. Uncontrolled diabetes is also associated with complications of the eyes, nerves, and kidneys.

Criteria for diagnosing Metabolic Syndrome

• A waistline of 40 inches or more for men and 35 inches or more for women (measured across the belly).
• A blood pressure of 130/85 mm Hg or higher or are taking blood pressure medications.
• A triglyceride level above 150 mg/dl.
• A fasting blood glucose (sugar) level greater than 100 mg/dl or are taking glucose-lowering medications.
• A high density lipoprotein level (HDL) less than 40 mg/dl (men) or under 50 mg/dl (women).

References:-

1..National Heart, Lung, and Blood Institute. What is Metabolic Syndrome Accessed 2/11/2015.

2. The American Heart Association. Metabolic Syndrome Accessed 2/11/2015.

3. International Diabetes Federation. IDF Worldwide Definition of the Metabolic Syndrome Accessed 2/11/2015.

4. Contributions of Telomere Biology to Human Age-Related Disease By lTing-Lin B.Yang ,ShufeiSong, BradJohnson