Skin manifestations
Some skin manifestations may provide clues to the onset of metabolic syndrome, allowing early diagnosis and treatment:
- Acanthosis nigricans (dirty brown to gray skin lesions, usually bilaterally symmetrical in axillae, flexures, and neck and genital areas) and multiple soft fibromas → evidence of insulin resistance (decreased or abolished action of the hormone insulin) and pathologic glucose tolerance (mild form of blood glucose elevation with fasting levels of 100-120 mg/dl)
- Xanthomas and xanthelasma → evidence of dyslipidemia (lipid metabolism disorder).
- Mycoses (fungal diseases: Candida infections; tinea) and pruritus (itching) (- 40% of diabetics) → evidence of diabetes mellitus type 2.
- Acne and hirsutism ( increased terminal hair (long hair) in women, according to the male distribution pattern) → indication of polycystic ovary syndrome (PCO syndrome; symptom complex characterized by hormonal dysfunction of the ovaries (ovaries)).
Obesity
- Android body fat distribution – male fat distribution, fat is predominantly located on the abdomen and thus the waist-to-hip ratio is ≥ 94 cm in men; ≥ 80 cm in women
- BMI (body mass index) > 25
- Early musculoskeletal problems – such as gon and coxarthrosis (knee and hip arthritis), degenerative spine problems.
- Indications of sleep apnea – breathing pauses at night, leading to daytime fatigue, as no restful sleep is possible at night-.
- Tendency to varicosis (varicose veins), thrombosis (formation of blood clots in the vessels), thrombophlebitis (inflammation of superficial veins) and edema (water retention in the tissues)-.
- Sweating after meals
Arterial hypertension
- Slight fatigability
- Palpitations (heart palpitations)
- Central nervous symptoms
- Headache – occurs mainly in the morning; often in the back of the head; improves after getting up.
- Dizziness
- Temporary visual disturbances
- Syncope – momentary loss of consciousness.
- Transient ischemic attack (TIA) – neurological deficits such as paralysis or sensory disturbances that, unlike apoplexy (stroke), resolve within 24 hours
- Nervousness
- Ringing in the ears
- Visual acuity deterioration (decreasing visual acuity) – symptom of hypertensive retinopathy (retinal changes due to prolonged high blood pressure).
- Epistaxis (nosebleeds) – occurs mainly in hypertensive crises.
- Sweating
- Nausea/vomiting
- Erectile dysfunction (erectile dysfunction)
- Signs of heart failure (cardiac insufficiency) or coronary artery disease (CAD; narrowing of the arteries supplying the heart)
- Exertional dyspnea (shortness of breath on exertion).
- Angina pectoris (sudden chest tightness)
- Nocturia (nocturnal urination)
Dyslipoproteinemia
- Xanthomas of the skin and tendons – raised small whitish fatty deposits.
- Eruptive xanthomas – xanthomas that break open.
- Planar xanthomas of the palms/knees – xanthomas located at the skin level.
- Xanthelasmata – symmetrical yellowish-white skin lesions on the eyelids and inner corner of the eye.
- Arcus lipoides corneae – fatty deposits in the eye; occurring before age 50 in men / age 60 in women, they are indicative of dyslipoproteinemia
- Acute pancreatitis (inflammation of the pancreas).
- Angina pectoris – “chest tightness”; sudden pain in the heart area.
- Neurological symptoms of inadequate perfusion (insufficient blood supply).
- Steatosis hepatis (fatty liver)
- Stenoses (narrowing) of the peripheral arteries and the neck arteries.
- Claudication intermittens – so-called shop window disease; due to narrowing of the leg arteries, the legs are insufficiently supplied with oxygen
Diabetes mellitus type 2
- Polyuria – Increased urination
- Polydipsia – Increased thirst.
- Weight loss
- Fatigue
- Pruritus (itching)
- Visual disturbances
- Erectile dysfunction (erectile dysfunction)
- Delayed wound healing
- Abdominal pain
- Lethargy
- Paresthesias (insensations) in the legs
- Pain in the legs
- Skin infections such as furunculosis (bacterial infection of several hair follicles at the same time) or candidamycosis (fungal infection with the fungus Candida albicans)
- Balanitis (inflammation of the glans)
- Recurrent (recurrent) therapy-resistant infections such as urinary tract infections (inflammation of the bladder and / or urethra).
Hyperuricemia (gout)
Symptoms of acute gout attackThe first attack occurs mainly at night. Arthritis urica (uric acid gout) is usually monoarticular (affects only one joint). Recurrences may occur during the following nights. Furthermore, it is possible that several joints are affected in succession.Arthritis urica is usually the indicator of the gout diseases (prevalence in a general practice: 1.5%). Joint
- Podagra – severe joint pain in the metatarsophalangeal joint of the big toe; other commonly affected joints are the knee and ankle joints.
- Reddened
- Overheated
- Strongly swollen
- Severe pain – mostly occurring abruptly
- Severe pain to the touch
- Restricted function
The typical features of inflammation (inflammation) hereby appear: Rubor (redness), Calor (hyperthermia), Tumor (swelling), dolor (pain) and Funktio laesa (impaired function). General signs of inflammation
- Fever (rare) – rather just shivering, mild fever.
- Headache (rare)
- Vomiting (rare)
- Tachycardia (heartbeat too fast: > 100 beats per minute) (rare).
Usually, the symptomatology subsides after 7-10 days even without therapy, often leaving scaling and skin itching over the affected joint. In women over 65 years of age, the middle and end joints of the fingers are also often affected, and acute attacks of gout in the lower extremities occur less frequently in this case. Symptoms of chronic gout
- Tophi (gouty nodules of uric acid crystals) – Localization: joints and soft tissues: Predilection sites (body regions where the disease preferentially occurs): ear cartilage, eyelids, nostrils, bursa, extensor sides of elbow joints.
- Uric acid crystal deposits in joints.
- Joint deformities
- Frequent attacks of pain
- Nephrolithiasis (kidney stones)
- Renal insufficiency (kidney weakness)
- Bursitis (bursitis)
- Swelling of the parotid gland (parotid gland).
