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DR. PAL is Assistant Professor, Dept. of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New HAven, CT, and Visiting Assistant Professor, Dept. of Obstetrics and Gynecology and Women's Health (Reproductive Endocrinolo
Beyond overt risks like obesity and diabetes, your patients with features of metabolic syndrome are at risk for more subtle problems--like infertility, pregnancy loss, and polycystic ovarian syndrome.
Clinicians across the various disciplines are all well aware of the cardiovascular implications of metabolic syndrome (MS) and its link to developing diabetes mellitus (DM).1 While there is ongoing controversy about all the implications that belong under the MS umbrella, there's nothing ambiguous about the adverse health threats of each of the individual metabolic risks-that taken together-define MS.2 We obstetricians and gynecologists have long been key players in primary and preventive health care for women. Never has our responsibility nor our role as "gatekeepers" to the health of present and future generations been clearer, however, than it is now. My goal here is to heighten the practicing ob/gyn's awareness of the many subtle and some overt morbidities that women with features of MS are at risk for. By recognizing these risks, we can act quickly with proven, targeted strategies to help reduce the burden of disease in our communities.
As the toll of obesity and related disorders escalates worldwide, emerging evidence suggests that a mother's metabolic profile affects the health of her future child.2,3 It's sobering to realize not just the scope of our responsibility to our pregnant patients, but also how short-sighted we've been in focusing only on the mother's metabolic status, while overlooking the metabolic patterns that women may be passing on to the next generation, which may not pose a threat to the health of their adult offspring for years!
Gynecologic perspective on metabolic syndrome