Acquired Chronic Metabolic Diseases refer to a group of long term metabolic disorders that develop due to environmental, lifestyle, and physiological factors rather than being inherited genetically. These conditions are progressive and often interrelated, contributing to an increased risk of cardiovascular diseases, organ damage, and overall health deterioration.

1. Common Types of ACMDs

Acquired Chronic Metabolic Diseases encompass various conditions affecting metabolism, energy regulation, and overall homeostasis. Some of the most common types include:

1.1 Type 2 Diabetes Mellitus (T2DM)

• Definition: A chronic metabolic disorder characterized by insulin resistance and progressive beta cell dysfunction, leading to high blood sugar levels.
• Complications: Neuropathy, nephropathy, retinopathy, cardiovascular diseases.
• ICD-10 Code: E11.9 (without complications), E11.65 (with hyperglycemia).

1.2 Metabolic Syndrome (MetS)

• Definition: A cluster of metabolic abnormalities that increase the risk of cardiovascular diseases and diabetes.
• Components:
  • Abdominal obesity (waist circumference >102 cm in men, >88 cm in women).
  • High triglycerides (>150 mg/dL).
  • Low HDL cholesterol (<40 mg/dL in men, <50 mg/dL in women).
  • Hypertension (BP >130/85 mmHg).
  • Elevated fasting glucose (>100 mg/dL).
• ICD-10 Codes: E88.810

1.3 Non-Alcoholic Fatty Liver Disease (NAFLD)

• Definition: Accumulation of fat in liver cells, leading to inflammation and fibrosis in severe cases.
• Complications: Cirrhosis, hepatocellular carcinoma, liver failure.
• ICD-10 Code: K76.0

1.4 Dyslipidemia

• Definition: Abnormal levels of cholesterol and lipids in the blood.
• Types:
  • Hypercholesterolemia: Elevated LDL cholesterol.
  • Hypertriglyceridemia: High triglyceride levels.
  • Mixed dyslipidemia: Combination of abnormal lipid levels.
• ICD-10 Code: E78.5

1.5 Hypertension

• Definition: Chronically elevated blood pressure that increases the risk of heart disease and stroke.
• ICD-10 Code: I10

1.6 Gout and Hyperuricemia

• Definition: Excess uric acid in the blood, leading to crystal formation in joints and tissues.
• ICD-10 Code: M10.9 & E79.0

1.7 Polycystic Ovary Syndrome (PCOS)

• Definition: A hormonal disorder in women associated with insulin resistance, irregular menstrual cycles, and metabolic disturbances.
• ICD-10 Code: E28.2

2. Criteria for Acquired Chronic Metabolic Diseases

ACMDs are diagnosed based on a combination of clinical, biochemical, and imaging criteria.

2.1 General Criteria for ACMDs

To be classified as an Acquired Chronic Metabolic Diseases, a disease must meet the following:
Develop over time (chronic nature) rather than being congenital.
Be influenced by lifestyle, environmental, and metabolic factors.
Result in metabolic dysfunction such as insulin resistance, lipid abnormalities, or chronic inflammation.
Have potential systemic complications, affecting multiple organs like the liver, pancreas, blood vessels, and kidneys.

2.2 Specific Diagnostic Criteria

• Type 2 Diabetes: Fasting glucose ≥126 mg/dL, HbA1c ≥6.5%.
• Metabolic Syndrome: Presence of at least 3 out of 5 risk factors (obesity, high blood pressure, dyslipidemia, hyperglycemia).
• NAFLD: Fat accumulation >5% in liver cells, detected via ultrasound or MRI.
• Dyslipidemia: LDL >160 mg/dL, triglycerides >150 mg/dL, HDL <40 mg/dL (men), <50 mg/dL (women).

3. Common Symptoms of ACMDs

Many Acquired Chronic Metabolic Diseases share overlapping symptoms, making early recognition essential.

3.1 General Symptoms

Fatigue and low energy levels : Due to metabolic inefficiencies.
Unexplained weight gain or difficulty losing weight :  Especially around the abdomen.
Increased thirst and frequent urination:  Common in diabetes and metabolic syndrome.
High blood pressure and headaches:  Seen in hypertension and metabolic disorders.
Abdominal discomfort or liver tenderness:  Suggestive of NAFLD.
Joint pain and inflammation:  Found in gout due to excess uric acid.
Skin changes:  Darkened skin patches (acanthosis nigricans) in insulin resistance.
Irregular menstruation and infertility:  A hallmark of PCOS.

3.2 Condition-Specific Symptoms

• Diabetes: Blurred vision, slow wound healing, frequent infections.
• Metabolic Syndrome: A combination of symptoms related to obesity, hypertension, and dyslipidemia.
• NAFLD: Fatigue, mild right upper quadrant pain.
• Dyslipidemia: Usually asymptomatic but may cause xanthomas (fatty deposits in the skin).
• Hypertension: Often silent but may cause headaches and dizziness.

4. Causes and Risk Factors of ACMDs

ACMDs arise from a complex interaction of genetic predisposition, lifestyle choices, and environmental influences.

4.1 Primary Causes

Poor dietary habits:  Excessive intake of processed foods, sugar, and saturated fats.
Sedentary lifestyle:  Lack of physical activity reduces metabolic efficiency.
Obesity:  Excess weight, particularly visceral fat, disrupts insulin function and lipid metabolism.
Insulin resistance:  A key driver of type 2 diabetes, PCOS, and metabolic syndrome.
Chronic inflammation:  Long term inflammation contributes to metabolic dysfunction.
Hormonal imbalances:  PCOS and other metabolic disorders are influenced by endocrine disruptions.
Liver dysfunction:  Fatty liver can lead to metabolic disturbances.

4.2 Risk Factors

• Age: Risk increases with age.
• Genetics: Family history can predispose individuals.
• Obesity and visceral fat accumulation.
• High sugar and processed food intake.
• Physical inactivity.
• Smoking and excessive alcohol consumption.

5. Management and Prevention

Lifestyle Modifications

• Adopting a balanced, whole-food diet (Mediterranean or DASH diet).
• Regular physical activity (150 minutes/week).
• Maintaining a healthy weight.
• Stress reduction techniques (yoga, meditation).

Medical Management

• Diabetes: Metformin, insulin therapy.
• Dyslipidemia: Statins, fibrates.
• Hypertension: ACE inhibitors, beta blockers.
• NAFLD: Weight loss, liver-supportive medications.

Regular Monitoring

• Blood glucose levels.
• Lipid profile and blood pressure.
• Liver enzymes and uric acid levels.

Conclusion

Acquired Chronic Metabolic Diseases  represent a growing global health challenge due to their strong links with lifestyle and environmental factors. Early diagnosis, lifestyle interventions, and appropriate medical management are key to preventing complications and improving long term health outcomes.