The Catalyst Issue 3 | Spring 2009 | Page 15

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 15