Újszeged Medical Center

DISORDERS OF FAT METABOLISM

Fat metabolism primarily occurs in the liver and adipose tissues, involving the synthesis and breakdown of fats and fat-like substances. This process is regulated by complex mechanisms, which are partly hereditary and partly influenced by proper or improper nutrition. Hormones play a crucial role in metabolism, such as insulin, adrenaline, thyroid hormones, and sex hormones. These emphasize the importance of inherited factors in fat metabolism, as the function of these hormones also depends on familial traits.

Fat metabolism disorders typically do not cause symptoms but pose a significant risk to life expectancy by greatly increasing the likelihood of cardiovascular diseases.

Excessive production of fatty acids can occur in parallel, where all fat-related values are abnormally elevated to varying degrees, or in isolation, where only specific values are affected.

Hypercholesterolemia
This condition involves elevated total cholesterol and LDL cholesterol ("bad cholesterol"), which may be accompanied by normal or abnormal HDL cholesterol ("good cholesterol"). The most unfavorable scenario is when LDL cholesterol levels are high, and HDL cholesterol levels are low. The more pronounced these deviations, the greater the cardiovascular risk. While proper nutrition plays a role in reducing these levels, scientific studies suggest that dietary measures alone can only achieve a reduction of around 10%.

Hypertriglyceridemia
Elevated triglyceride levels are often accompanied by increased blood sugar or uric acid levels. Mild deviations are common even in young people and may indicate a higher risk of developing type 2 diabetes later in life. In recent years, this condition has been strongly associated with the development of fatty liver. Reducing the consumption of starchy foods and alcohol can lower triglyceride levels, though significant reductions cannot be expected from dietary changes alone.

Mixed Dyslipidemia
This condition involves elevated levels of multiple types of fats mentioned above.

PREDIABETES

Impaired Fasting Glucose (IFG): Fasting blood glucose levels above 6.1 mmol/L but below 7 mmol/L. In such cases, an oral glucose tolerance test (OGTT) is recommended. Here, the 2-hour glucose value remains below 7.8 mmol/L.

Impaired Glucose Tolerance (IGT): Fasting glucose levels may be below 6.1 mmol/L, but the 2-hour value after glucose loading falls between 7.8 and 11.1 mmol/L.

High blood glucose levels can damage the cardiovascular system even in the absence of diabetes, during the so-called prediabetes stage. Therefore, it is highly recommended to monitor blood glucose levels annually to detect carbohydrate metabolism abnormalities early.

DISORDERS OF URIC ACID METABOLISM

High uric acid levels not only cause gout but are increasingly recognized as closely linked to other conditions such as hypertension, diabetes, kidney disease, and metabolic syndrome. Elevated serum uric acid is a significant risk factor for cardiovascular and kidney diseases. Among those with cardiovascular diseases, diabetes, or hypertension, high uric acid levels are three times more common.

Uric acid is produced from purines, which are part of proteins. These are partly generated during digestion in the digestive system and partly released from decaying cells, with uric acid being the final breakdown product that enters the bloodstream. In healthy individuals, about two-thirds of uric acid is excreted through the kidneys, while the rest leaves the body via digestive secretions and sweat. An equilibrium exists between production and excretion. If a regulatory issue arises, uric acid accumulates in cells and intercellular spaces. The typical manifestation is a gout attack, most often affecting the big toe, which becomes swollen, red, and extremely painful to touch or move. Gout may occur in men around 40–50 years old and in women after menopause.

Gout is often hereditary and can be caused by excessive uric acid production or reduced excretion. Secondary forms are significantly influenced by obesity, poor nutrition, alcohol consumption, and certain medications. Recent studies emphasize that treating high uric acid levels is essential not only to prevent chronic joint issues but also to reduce cardiovascular risks significantly. Treatment involves both medication and dietary management.

HYPERTENSION (HIGH BLOOD PRESSURE)

Hypertension is a widespread condition and is a leading cause in 80–90% of cardiovascular diseases. It often remains untreated for years as it usually causes no symptoms. Many patients stop their prescribed medication within weeks or months, mistakenly believing they no longer need treatment when their blood pressure normalizes. However, hypertension is not curable but can be effectively managed. Early diagnosis and appropriate treatment are crucial to improving patients' quality of life and reducing cardiovascular mortality.

Blood pressure fluctuates constantly throughout the day, adapting to internal and external conditions. Hypertension is diagnosed when the average of three measurements taken at one-week intervals is 140/90 mmHg or higher. In individuals with additional risk factors or metabolic disorders, the threshold is 135/85 mmHg, which also applies to home measurements. Elevated values must be treated regardless of age, typically with medication, after excluding secondary causes like thyroid or kidney disorders.

Contrary to misconceptions, good blood pressure readings during treatment do not indicate a cure. Numerous studies confirm that starting appropriate therapy early, even in young adults, ensures decades of good cardiovascular health. While medications may have side effects, they are far less harmful than the irreversible damage caused by untreated hypertension.

If you suspect you fall into any of these risk groups or experience similar symptoms, laboratory testing is recommended.

Laboratory tests without waiting times are available in Szeged and surrounding areas on weekdays from 5:30–8:00 a.m. by appointment.

Fasting blood tests are most informative during these hours, as key risk-related data may vary throughout the day due to fluctuations, potentially leading to misleading results.

Based on lab results, consultations are available with our diabetologists, cardiologists, neurologists, hypertension specialists, and, if necessary, dietitians.

COMPREHENSIVE SCREENING PACKAGE FOR COMPLICATIONS

• Laboratory Testing – Risk Screening (Blood lipids, uric acid, HbA1c, body fat, BMI, blood pressure)
• Urine Analysis for protein screening
• Neurometer testing for nerve damage
• ECG for coronary artery screening
• Doppler Examination to check for peripheral arterial narrowing