A Killeen teenager gets a wake-up
call about her health
Two years ago, 15-year-old Maria Gomez* faced a tough set of circumstances. Moving from Guam,
a small island in the South Pacific, to Killeen, TX, she was grappling with a new environment,
academic and social pressure and her weight. Her battle was just beginning, when she was told
that she had a cluster of symptoms that can lead to premature diabetes and cardiovascular
disease (hardening of the arteries that can lead to heart attacks, stroke or blockages in the leg
arteries) in adulthood. Now she has a new lease on life, due in large part to the expertise of
Catherine McNeal, MD, PhD, a pediatrician and internist at Scott & White Healthcare.
M
etabolic syndrome (MetS) is an
acute and collective medical
concern because 47 million
American adults—about 25 percent of the
adult population—have it, according to
the National Heart, Lung, and Blood
Institute. Although the diagnosis in youth
is controversial, there is little doubt that
having multiple risk factors for developing
diabetes and cardiovascular disease is an
alarming and increasingly frequent
observation made by many healthcare
providers of today’s youth. Because of
these factors, the current generation of
children is the first who may not outlive
their parents.
The same features that we associate
with the metabolic syndrome in adults
can be present in overweight youth as
well. Many adults don’t know they
have MetS. The components include
an increased waist circumference (an
alternate measure of being overweight);
elevated blood sugar but not necessarily
diabetes; high triglycerides and elevated
blood pressure (not high enough to be
called hypertension); and low levels of
HDL or “good” cholesterol. If an adult
has at least three of the five risk factors,
they are twice as likely as a healthy person
to develop heart disease and five times as
likely to develop diabetes, both lifethreatening diseases. MetS appears to be
more prevalent in women in minority
populations, and family history plays a
role both through genetics as well as
eating and exercise habits learned from
our families.
Dr. McNeal compares MetS to a large,
dangerous iceberg, with measurable
factors above the surface, and others
underneath that are full of surprises. “The
sum of the components is much more
dangerous than any of the parts, none of
which are desirable,” says Dr. McNeal.
Other less visible symptoms, such as
inflammation of the arteries and other
abnormalities that are not easily
measurable, such as an increased tendency
to form blood clots, can further
complicate a patient’s case. “When
multiple risk factors for diabetes and
cardiovascular disease are present, it is
worrisome, but we have a considerable
* a pseudonym
Spring 09 THE CATALYST
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