Clinical Antiaging Medicine: Obesity, Metabolic Syndrome, and Antiaging Medicine

Metabolic syndrome is a preventive medical disease concept that positions the excessive accumulation of “visceral fat tissue” located in an anatomical position that can directly affect the nutrition and energy metabolism of the liver, such as mesenteric fat tissue and omental fat tissue, whose venous return merges into the portal vein, as the most upstream pathological condition, aiming to prevent the onset and progression of atherosclerotic diseases, including coronary artery disease. The formation of metabolic syndrome involves a variety of combinations for each individual, such as decreased physical activity, overeating or unbalanced diet, broad stress, biological rhythm disorders, aging, racial/ethnic differences, genetic background, and endocrine system dysfunction, and the decline in organ and vascular function with aging has a significant impact on the progression and worsening of metabolic syndrome [1]. In metabolic syndrome, insulin resistance, hyperglycemia, lipid metabolism abnormalities (especially hypertriglyceridemia, low HDL-C), hypertension, etc., a group of risk factors for atherosclerotic diseases and type 2 diabetes accumulate in various combinations in the same individual, and it is also important as an intervention target for the prevention of the onset of type 2 diabetes and hypertension, whose risk of onset increases with age. High LDL-C is an established risk factor for atherosclerotic diseases, and there is no direct causal relationship with excessive accumulation of visceral fat, so it is not included in the diagnostic criteria for metabolic syndrome, but of course, in metabolic syndrome with high LDL-C, it is desirable to further strengthen the guidance and management to improve lifestyle habits and reduce visceral fat [2]. The risk of developing type 2 diabetes in metabolic syndrome is about 3–6 times higher than in non-metabolic syndrome. Also, the risk of cardiovascular disease onset and cardiovascular disease death in metabolic syndrome is about 1.5–2 times higher than that in non-metabolic syndrome. The purpose of guidance and management for those with metabolic syndrome is particularly to prevent the onset and progression of type 2 diabetes and cardiovascular disease, and the key is to improve lifestyle habits, including diet therapy, exercise therapy, smoking cessation, and reduce visceral fat [2].