December 2014, Volume 36, No. 4
Internet

What’s on the web for family physicians – Metabolic syndrome and obesity

Alfred KY Tang 鄧權恩, Man-wo Tsang 曾文和

1. Obesity---Obesitext
http://www.endotext.org/section/obesity/

At Endotext.org (http://www.endotext.org/), all the educational materials on endocrine diseases are written by physicians expert in the field, and targeted to physicians worldwide. The section on Obesity (Obesitext) has chapters covering obesity, its treatment and prevention, and metabolic syndrome.  Educational materials on influencing factors, clinical pathophysiology and health implications of obesity are available.   Treatment approaches of obesity are outlined, including pharmacological, exercise, dietary, behavioral modification and surgical treatment. A simple registration process at the website is required for access of information which is free of charge.  

2. Obesity and the Metabolic Syndrome 
http://www.merckmanuals.com/professional/nutritional_disorders/obesity_and_the_metabolic_syndrome/obesity.html

The professional edition of the Merck Manual Online have sections dedicated to Obesity, Bariatric Surgery and Metabolic Syndrome. There are chapters covering prevalence, etiology, complications and complications of obesity.  For metabolic syndrome, there are discussions on definitions, diagnostic criteria and clinical implications.  For bariatric surgery, its indications, procedures and complications are outlined.

3. Guidelines on Overweight and Obesity: Electronic Textbook
http://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/intro/12.htm

This online textbook allows easy access to information contained in "The Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report," prepared by the National Heart, Lung, and Blood Institute (NHLBI) in cooperation with the National Institute of Diabetes and Digestive and Kidney Diseases. Topics addressed in the Clinical Guidelines include the health risks associated with obesity; and assessment, treatment, and management of obese patients. The complete text can be downloaded in PDF format at http://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/obesity-evidence-review.pdf.The objective of the publication is to evaluate and summarise currently available information on assessment and treatment of obesity, and then to provide evidence-based guidelines for physicians for the evaluation and treatment of obesity.  It also helps to identify areas for future research.

4. Obesity Action Coalition (OAC)
http://www.obesityaction.org/

The focus of OAC is to raise awareness and improve access of educational materials on prevention and treatment of obesity, thus providing evidence-based education on obesity and its treatments.  It also helps to eliminate weight discrimination, aggregate the strength of voice on obesity and its impact on health and offer community support for the individual affected.   The Obesity Action Alert E-newsletter (http://www.obesityaction.org/educational-resources/obesity-action-alert) is a free monthly electronic newsletter. This e-newsletter features current obesity news in addition to news about the OAC. In the section on Education Resources, there is a library of articles ranging from childhood obesity, medically managed weight loss, bariatric surgery to many other obesity related articles.

5. International Diabetes Federation (IDF)
http://www.idf.org/metabolic-syndrome

The metabolic syndrome is a cluster of heart attack risk factors: diabetes and prediabetes, abdominal obesity, high cholesterol and high blood pressure. IDF believes that it is driving the twin global epidemics of type 2 diabetes and cardiovascular diseases.  It would be more important to identify those individuals with metabolic syndrome early, so that lifestyle interventions and treatment may prevent the development of diabetes and/or cardiovascular disease.  IDF has then launched a new definition to identify children and adolescents at increased risk of developing type 2 diabetes and cardiovascular disease in later life. The definition has been published in The Lancet and is also available as a booklet, downloadable at http://www.idf.org/webdata/docs/MetS_def_update2006.pdf. Metabolic syndrome and diabetes are in fact way ahead of HIV/AIDS in terms of morbidity and mortality, yet, the problem is not well recognised.

6. The Controversial Question of Metabolic Syndrome
http://www.ajmc.com/publications/evidence-based-diabetes-management/2013/2013-1-vol19-sp2/the-controversial-question-of-metabolic-syndrome

The increasing prevalence of diabetes and cardiovascular disease (CVD) alerts the medical community not only to treat but to better identify people at risk for these diseases.  However, different organisations have different criteria for metabolic syndrome. Even the concept of metabolic syndrome is somewhat controversial. Many believe that insulin resistance is strongly associated with obesity. On the other hand, some believe that insulin resistance contributes to the development of the risk factors but is not the underlying cause. Identifying a cluster of predictive risk factors would enable healthcare providers to identify and treat patients with metabolic syndrome, thus reducing the risk for a progression to diabetes, CVD, or both. 

7. Diabetology & Metabolic Syndrome
http://link.springer.com/journal/13098

Diabetology & Metabolic Syndrome is an open access, peer-reviewed journal published on behalf of the Brazilian Diabetes Society. It encompasses different aspects of the pathophysiology of diabetes and metabolic syndrome.  The journal aims to offer an online forum, for exchange of new insights and knowledge on the subject, with the ultimate aim of stimulating and setting directions for further research in the field. 


Alfred KY Tang, MBBS (HK), MFM (Monash)
Family Physician in Private Practice

Man-wo Tsang, MBBS (HK), FHKCP, FHKAM (Medicine), FRCP (L.E.G.)
Endocrinologist in Private Practice

Correspondence to: Dr Alfred KY Tang, Shop 3A, 2/F, Hsin Kuang Shopping Centre, Wong Tai Sin, Kowloon, Hong Kong SAR, China.

E-mail: alfredtang@hkma.org