Chapter 3 Chapter 1 The Deadly Quartet

Decades ago, this gang of four was judged as the murderer, and became a household name because they were wanted everywhere.Nevertheless, they come more and more ferociously, sometimes in pairs, sometimes in groups of three, and sometimes in packs.According to the latest information, in addition to the four main offenders, there are at least three to four accomplices.There are even a large number of supporters and accomplices supporting them.We have yet to fully appreciate the impact and potential dangers of this type of organized crime.In the future, everyone must go all out to arrest them in order to know the background and specific methods of committing crimes of this criminal group.However, there is still no global consensus on what they should be called

This phenomenon was first proposed by experts in the 1950s and was included in the arrest list in 1984 as the deadly quartet: hypertension, hyperlipidemia, hyperglycemia and hyperinsulinemia.It was observed quite frequently at that time that forty to fifty percent of hypertensive patients also had other disorders mentioned here.This is especially typical for obese people.In 1968, Munich's Helmut.Professor Helmut Mehnert called this medical phenomenon of obesity the affluence syndrome, and the title really hits the nail on the head! The coexistence of high blood pressure, high blood fat, high blood sugar and hyperinsulinemia cannot be tolerated by even the strongest people for a long time, let alone those with weak circulatory systems.Sooner or later, it will lead to other serious diseases

In Europe, the incidence of myocardial infarction has stagnated or declined for a while, but has rebounded in recent years.In February 2000, Ruth.Dr. Ruth Strasser announced the amazing data she studied in Germany at the Dresden Cardiac and Circulatory Medicine Conference: More and more young people aged 20 to 25 suffer from myocardial infarction infarction!How can this be explained?What exactly has changed?Are we eating more and more fat?Absolutely not!Do you eat too much butter, eggs and meat?No, the opposite is true, consumption of these foods has even decreased.Is it elevated cholesterol?Not at all.Every suspect we could think of had a conclusive alibi.So we suspect that the deadly quartet is back, but also sometimes in a trio or sextet, depending on how many criminals were involved at the time of the attack.

Jerrod of Stanford University in California.Professor Gerald M. Reaven put forward an argument in 1988 that insulin resistance is the main structure of symptoms such as hypertension, hyperlipidemia, hyperglycemia, and hyperinsulinemia.Since the relationship between them could not be further determined at that time, he called this phenomenon the unknown syndrome.This name is mainly used in English-speaking countries.The Germans have long used the term metabolic syndrome, which actually means the same thing.But in the end, insulin resistance syndrome (IRS) was adopted internationally.There are currently three or four other names, but for various reasons, they are not satisfactory.In writing this book, I decided to avoid the arguments of the experts and chose the concept of unknown syndrome because of the simplicity of the word and its mysterious color.

In 1998, the research team led by Professor Li Wen finally obtained the final evidence, proving that insulin resistance and the chronic increase of insulin levels are indeed the root causes of all heart and circulatory system diseases. Insulin is a hormone that is produced by the pancreas and secreted into the blood vessels.It functions like a key, opening the cell wall so that glucose in the blood can enter the cell and be converted into energy.Insulin resistance refers to the inhibition of the body's cells' ability to absorb sugar from the blood.Unfortunately, insulin resistance is asymptomatic and the victim has no way of noticing it. The dysfunction can only be diagnosed with a special blood test (see Chapter 2).

If the body's cells are unresponsive to the insulin signal, the pancreas must pump more insulin into the blood to achieve the signal strength necessary to allow the sugar to enter the cells.Initially, the insulin resistance of the cells can be balanced by continuously increasing insulin levels in the blood.At this time, if a person's blood sugar level can be controlled within the normal range, then although he suffers from hyperinsulinemia, his glucose tolerance is still normal. The more cells that need nourishment from the body, the greater the amount of insulin required.If a person makes millions of fat cells when they are young and strong, the body needs more insulin.Obese people have to constantly make more insulin than lean people.As there are more and more obese people in the world, it is no wonder that there will be more and more people whose pancreas is unable to secrete insulin to meet their lifelong needs.Less insulin means less regulation, leading to higher blood sugar.This is what is known as impaired glucose tolerance.The less insulin secreted, the higher the blood sugar content.To a certain extent, the formation of abnormal glucose tolerance, and even develop into diabetes.If the secretion of insulin is completely exhausted, it becomes insulin-dependent type 2 diabetes.

How did this defect come about?Since insulin resistance is only thirty percent genetically determined, environment and lifestyle must play a larger role.While that means we're groping in the dark, there's still a great chance of catching these murderous gangs and getting out of trouble.I can guarantee that we will explore the most crucial clues in this book. Diabetes is the most well-known and well-studied disease among the unknown syndromes.Once upon a time, type 2 diabetes was a disease of elderly, well-fed husbands and wives, but today it is a worldwide epidemic.Such a high incidence is not just due to the increase in the average life expectancy of human beings and the trend of the so-called age pyramid in demographics.Millions of new patients are increasing in middle age, and more and more young people in their 20s and 30s are joining the ranks of older diabetics and type 2 diabetics.Be careful not to confuse them with juvenile diabetes and type 1 diabetes, which only occur during adolescence (see Appendix 1).At the end of the 20th century, the World Health Organization (WHO) estimated that there were 135 million diabetics worldwide.However, the number of patients who are already sick but still unknowingly must be many.Based on current trends, the World Health Organization estimates that by 2005, nearly 300 million people worldwide will suffer from diabetes.

Some readers may not think of diabetes as a serious problem. There are so many amiable grandparents around, all suffering from diabetes in their later years, and everyone has become accustomed to it.But in fact, diabetes is not a common disease, and almost all risk factors for vascular disease are covered in patients (see Chapter 2).The consequences are severe, often worse, such as blindness and kidney failure.The incidence of leg amputation in diabetic patients is also 30 times higher than that of the general population.Elderly people with diabetes are two to four times more likely to die from myocardial infarction or cerebrovascular infarction than those without diabetes.As if that wasn't enough, they were more prone to cancer.We will discuss this in detail in the next chapter.

Fifty years ago, type 2 diabetes was uncommon in the world.Now in developed countries in Europe, the United States, Australia and New Zealand, diabetes has accounted for 5%︱6% of the total population, which has reached the scale of national disease.This ratio will increase by about 8% within 25 years.In recent decades, the Middle East, India and South America have followed suit. Basically, the wealthier a country is, the rounder its people's bellies, and the more diabetics it will be.However, compared with other races, Caucasians of European descent are less likely to suffer from this disease.In the United States, 10 percent of blacks and 12 percent of Hispanics now suffer from diabetes.

It is noteworthy that among those who, in the last generation or two, immigrated from non-industrial civilizations or developing countries to developed countries and suddenly entered the Western way of life, a large number of people developed diabetes.For example, among the Pima Indians living in Arizona, the incidence rate of diabetes has reached 38%.A similar situation also occurs in Aboriginal Australians and residents of many Pacific islands such as Nauru (Nauru), where the prevalence rate of these residents is as high as 15%︱25%.In The Hague, Netherlands, nearly 40% of immigrants from Southeast Asia over the age of 60 suffer from diabetes.In Japan, which has not accepted the Western life style for a long time, the situation is even more serious: from 1976 to 1995, the incidence of diabetes among school-age adolescents increased thirty-fold!

However, diabetes is just the tip of the iceberg.It is estimated that twenty percent, and in some regions perhaps thirty percent or more, of persons considered healthy worldwide are insulin resistant.So far, many people cannot believe that this is a prelude to diabetes, and it is just as dangerous.Because they are not aware of these dangers, everyone has no way to pay attention to them.Nowadays, even every child knows their cholesterol levels, but who knows their blood sugar and insulin values?In fact, this may be a serious mistake, because these two numbers are far more important to your health than cholesterol levels! The latest scientific analysis confirms that insulin resistance and chronic hyperglycemia, even if it does not reach the level of diabetes, are enough to pose a serious threat to health, especially to the heart and circulatory system.Chronic increases in insulin levels have also been identified as a risk factor affecting health.We will discuss it in detail in the next chapter. More recently, cellular mechanisms of insulin resistance have also been discovered.This is a malfunction of a transporter in the cell membrane that is responsible for transporting glucose into muscle cells.The reason for this malfunction has not been studied.It naturally includes genetic factors formed under different conditions, but on the other hand, the environment and living conditions caused by humans are obviously more important.This is also illustrated by the fact that different ethnic groups around the world, with different genetic conditions, are also facing a surge in insulin resistance and diabetes. If more and more young people aged 20 to 25 die of myocardial infarction, the biggest suspicion can only be counted as unknown syndrome.However, where would young people go for routine health checks against this danger?This situation has to change, because if it is really tested, many symptoms of insulin resistance can be found in young people as young as nineteen years old.We will also explore this phenomenon in depth in the next chapter. Once diagnosed with impaired glucose tolerance or diabetes, although it is not good news, the earlier it is found, the more effective relative measures can be taken, as we will see later. Although everyone talks about mad cow disease and AIDS, the unknown syndrome is the health killer of our era!Insulin resistance can be found in everyone, regardless of gender, age, height, height, or weight.If the number of people threatened reaches 20%︱30% of the total population according to different countries and regions, that is to say, one out of every four people, then there are billions of people in the world who are its victims.In a country like Germany, this means that the health of nearly 20 million people is at risk, most of them are still in the dark, and the number is still increasing at an explosive rate, but who is talking about this What's the problem?Where is the media propaganda? All this would be a colossal disaster!First of all, it should be noted that the state and society are adding fuel to the fire, and the current economic and cultural policies, transportation and urban planning, contribute to the conditions for the outbreak of unknown syndromes.What we are facing may be an unprecedented epidemic disease. At the end of this chapter, we must first understand a problem: If the unknown syndrome is widespread and related to genes, and on the other hand, it endangers human life, why is it so fatal? Didn't their genetic genes go extinct with their bearers in the past tens of thousands of years?Because genes that endanger survival usually disappear with a high profile in the evolutionary process, the fittest survive, and the unfit are eliminated.Can we think that, genetically speaking, insulin resistance should be a survival advantage, at least until recent stages of evolution.Perhaps under certain living conditions, increasing cells' resistance to insulin is a good thing.It is not without reason that this characteristic is deeply embedded in our chromosome arrangement. A very interesting question is, under what living conditions does mass insulin resistance arise, when does it have a positive or negative impact on health, and what are the inappropriate behaviors in our current lifestyle?Since insulin resistance is directly related to sugar and food, it must be actively clarified whether the way we eat today has anything to do with this adverse progression.What kind of food is good for our health, after all, is not determined by nutrition consultants, but by our genes.Let's take a closer look then. Appendix What is diabetes? One of the most common consequences of insulin resistance is diabetes.From the perspective of etiology, it must be strictly divided into two categories: Type 1 diabetes patients, congenitally lacking insulin.As we know today, they don't have to go on a diet, but they have to inject a certain dose of insulin according to the proportion of carbohydrates in the food.Without insulin, their sugar metabolism is completely out of balance; the consequence is that the blood vessels in the heart, kidneys and eyes are severely damaged in adolescence, often leading to premature death.5%︱10% of diabetic patients are type 1 diabetes. In contrast, patients with type 2 diabetes are only relatively deficient in insulin.Compared with healthy people, they absorb only half of the glucose into their cells when they consume large amounts of sugar.In people with type 2 diabetes, insulin's action on cells is suppressed.The reason is that there is a problem with the junction and delivery of the hormone insulin, and the body tries to make up for this deficiency by making the pancreas produce more insulin.Depending on the extent of compensation, the sugar balance in the body remains normal or only slightly out of balance.In this case, a person has a dysregulated sugar metabolism, so-called impaired glucose tolerance, but does not yet have diabetes. In addition, another adverse symptom accompanying these people is that the liver secretes too much sugar, so the body needs more insulin.At the same time, the resistance of the cells to insulin is getting stronger and stronger. Finally, one day, the ability of the pancreas to provide insulin can no longer meet the increasing demand for dosage.Although the level of insulin in the body is still quite high, the concentration of blood sugar in the blood remains high.This type of diabetes is called non-insulin-dependent type 2 diabetes. Over time, the pancreas gradually fails to make insulin.When eating carbohydrate-rich foods, the body's ability to secrete insulin goes from bad to worse, and sooner or later the patient will have to start taking insulin injections.This is insulin-dependent type 2 diabetes. According to the previous definition of the World Health Organization, when a person's fasting blood glucose concentration exceeds 110 mg per 100 ml, it is abnormal insulin tolerance, and if it exceeds 140 mg per 100 ml, it is diabetes.More recently, this standard has been revised more stringently, as people recognize that even slightly elevated blood sugars are potentially dangerous. According to the new standard, the upper limit of normal blood sugar concentration on an empty stomach is 110 milligrams per 100 milliliters.Between 110 and 126 milligrams, the fasting blood sugar concentration is too high, and if it exceeds 126 milligrams per 100 milliliters, it is diabetes.