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Metabolic Syndrome

Metabolic syndrome or Syndrome X, is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes. It is characterized by “insulin resistance,” which is a prediabetic state and markedly increases the chance that you will develop coronary heart disease and/or diabetes. It is a very significant risk factor and calls for emergency preventive measures.

What Causes It?

Metabolic syndrome is becoming more and more common in the United States. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity.

The two most important risk factors for metabolic syndrome are:

  • Extra weight around the middle and upper parts of the body (central obesity). The body may be described as “apple-shaped.”
  • Insulin resistance, in which the body cannot use insulin effectively. Insulin is needed to help control the amount of sugar in the body. As a result, blood sugar and fat levels rise.

Other risk factors include:

  • Aging
  • Genes that make you more likely to develop this condition
  • Hormone changes
  • Lack of exercise

Peole who have metabolic syndrome often have two other problems that can either cause the condition or make it worse:

  • Excess blood clotting
  • Low levels of inflammation throughout the body

Signs and Symptoms

Metabolic syndrome is characterized by extra weight around your waist (central or abdominal obesity). According to the American Heart Association and the National Heart, Lung, and Blood Institute, metabolic syndrome is present if you have three or more of the following signs:

  • Blood pressure equal to or higher than 130/85 mmHg
  • Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
  • Large waist circumference (length around the waist):
    • Men – 40 inches or more
    • Women – 35 inches or more
  • Low HDL cholesterol:
    • Men – under 40 mg/dL
    • Women – under 50 mg/dL
  • Triglycerides equal to or higher than 150 mg/dL

Tests that may be done to diagnose metabolic syndrome include:

  • Blood pressure measurement
  • Glucose test
  • HDL cholesterol level
  • LDL cholesterol level
  • Total cholesterol level
  • Triglyceride level

Treatment for Metabolic Syndrome

The goal of treatment is to reduce your risk of heart disease and diabetes. Your doctor will recommend lifestyle changes or medicines to help reduce your blood pressure, LDL cholesterol, and blood sugar.

Recommendations include:

  • Lose weight. The goal is to lose between 7% and 10% of your current weight. You will probably need to eat 500 – 1,000 fewer calories per day.
  • Get 30 minutes of moderate intensity exercise, such as walking, 5 – 7 days per week.
  • Lower your cholesterol using weight loss, exercise, and cholesterol lowering medicines, if needed.
  • Lower your blood pressure using weight loss, exercise, and medicine, if needed.

Some people may need to take daily low-dose aspirin.

People who smoke should quit.

Complications of Metabolic Syndrome

People with metabolic syndrome have an increased long-term risk for developing cardiovascular disease and type 2 diabetes. Complications can include:

References

Mahley RW, Weisgraber KH, Bersot TP. Disorders of Lipid Metabolism. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 36.

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention: National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640-1645.

Rosenzweig JL, Ferrannini E, Grundy SM, Haffner Sm, Heine RJ, Horton ES, et al. Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93:3671-3689.