Metabolic syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes. It affects one in five people, and prevalence increases with age. Some studies estimate the prevalence in the USA to be up to 25% of the population.
The metabolic syndrome is characterized by a group of metabolic risk factors in one person. They include:
- Abdominal obesity (excessive fat tissue in and around the abdomen)
- Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
- Elevated blood pressure
-Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
-Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
-Proinflammatory state (e.g., elevated C-reactive protein in the blood)
The exact mechanisms of the complex pathways of metabolic syndrome are not yet completely known. Most patients are older, obese, sedentary, and have a degree of insulin resistance. Stress can also be a contributing factor.
There is debate regarding whether obesity or insulin resistance is the cause of the metabolic syndrome or if they are consequences of a more far-reaching metabolic derangement. Central adiposity is a key feature of the syndrome, reflecting the fact that the syndrome's prevalence is driven by the strong relationship between waist circumference and increasing adiposity. However, despite the importance of obesity, patients that are of normal weight may also be insulin-resistant and have the syndrome.
The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance. Insulin resistance is a generalized metabolic disorder, in which the body can’t use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.
The American Heart Association and the National Heart, Lung, and Blood Institute recommend that the metabolic syndrome be identified as the presence of three or more of these components:
* Elevated waist circumference:
Men — Equal to or greater than 40 inches (102 cm)
Women — Equal to or greater than 35 inches (88 cm)
* Elevated triglycerides:
Equal to or greater than 150 mg/dL
* Reduced HDL (“good”) cholesterol:
Men — Less than 40 mg/dL
Women — Less than 50 mg/dL
* Elevated blood pressure:
Equal to or greater than 130/85 mm Hg
* Elevated fasting glucose:
Equal to or greater than 100 mg/dL
For managing both long- and short-term risk, lifestyle therapies are the first-line interventions to reduce the metabolic risk factors. These lifestyle interventions include:
* Weight loss to achieve a desirable weight (BMI less than 25 kg/m2)
* Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on
most days of the week
* Healthy eating habits that include reduced intake of saturated fat, trans fat and cholesterol