What is Metabolic Syndrome?
The metabolic syndrome, also called insulin resistance
syndrome or syndrome X, is not a disease but a group of signs and symptoms
including obesity, high blood pressure, elevated blood sugar levels, and high
triglycerides (fat-like substances in the blood).
Why is metabolic
syndrome a serious problem?
Having a combination
of these characteristics increases your risk of developing type 2 diabetes and
heart disease. Keeping your weight, blood sugar, and cholesterol and
triglyceride levels under control can help you to live longer and decrease your
risk of heart attack and stroke.
How do we diagnose metabolic syndrome?
Most expert groups define metabolic syndrome as the presence
of three or more of the following characteristics in a person:
- Obesity as seen by waist size greater than 90cm in South-East
Asian men or greater than 80 cm in South-East Asian women
- Fasting blood sugar >5.6mmol/L or previously diagnosed
with Diabetes
- Increased blood pressure (130/85 mmHg or higher) or if you
take medicine for high blood pressure
- Increased fasting levels of triglycerides (greater than 1.7
mmol/L) or if you take medicine for high triglycerides or low HDL cholesterol
- Decreased fasting high-density lipoprotein (HDL) cholesterol
(less than 1.03 mmol/L for men or 1.29 mmol/L for women) or if you take
medicine for high triglycerides or low HDL cholesterol
How common is metabolic syndrome?
Metabolic syndrome is
becoming increasingly common. About 22 to 34% of people have metabolic
syndrome.
The following factors are thought to increase the risk of
developing metabolic syndrome:
- Being overweight (body mass index of 25 kg/m2 or more)
- Menopause (in women)
- Increasing age
- Smoking
- Eating a high-carbohydrate diet
- Lack of physical activity
- Family history of diabetes or metabolic syndrome
What are the health risks associated with metabolic
syndrome?
Type 2 diabetes is much more likely to develop among people
with the metabolic syndrome. Healthy lifestyle changes, such as weight loss and
exercise, can help to reduce the risk of developing type 2 diabetes.
People with metabolic syndrome are at increased risk for
developing cardiovascular disease. Cardiovascular disease includes coronary
artery disease (collections of fatty material inside the heart's blood
vessels), cerebrovascular disease (collections of fatty material inside the blood
vessels leading to the brain), and high blood pressure. Cardiovascular disease
can lead to heart attack and stroke.
What are the investigations or lab tests we can do for
metabolic syndrome?
The metabolic syndrome is diagnosed based upon a physical
exam and some blood tests. These include:
- Measurement of blood pressure and body weight;
- Measurement of waist circumference;
- Measurement of fasting blood sugar; and
- Full lipid profile (panel of tests to check the levels of
your good and bad cholesterol)
What is the treatment for metabolic syndrome?
The goals of treatment for the metabolic syndrome are to:
- Reduce or eliminate underlying problems (eg, obesity, lack
of activity) by losing weight and becoming more active.
- Treat cardiovascular risk factors, such as high blood
pressure and cholesterol, if these problems persist despite losing weight and
exercising.
Management of the metabolic syndrome usually includes losing
weight and becoming more active.
- Your diet should be low in fat and cholesterol.
- The Mediterranean diet is high in fruits, vegetables, nuts,
whole grains, and olive oil. This diet can help to lower weight, blood
pressure, lipids, and improve insulin resistance.
- The DASH (Dietary Approaches to Stop Hypertension) diet can
reduce blood pressure, weight, lipids, and fasting blood glucose levels. The
DASH diet requires you to eat no more than 2400 mg of sodium per day, four to
five servings of fruit, four to five servings of vegetables, two to three
servings of low-fat dairy products, and all foods must contain less than 25
percent total fat per serving.
- Exercise
- Exercise can help with weight loss and can also help to
reduce the size of the abdomen, especially in women. Experts recommend at least
30 minutes of moderate physical activity, such as brisk walking, most days of
the week.
- If diet and weight loss do not adequately reduce your LDL
levels or blood pressure, a medicine may be recommended.
- Quit smoking
- Smoking cigarettes significantly increases
the risk of coronary artery disease and has many other health risks as well.
You and your family are strongly advised to stop cigarette smoking.
References:
Uptodate
Disclaimer: This article provides general advice for the
public. Please seek official advice from your primary physician.
