Metabolic syndrome. A rich man's disease in developed countries.

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.