- What Is It?
- How to Prevent
What Is Metabolic Syndrome?
Metabolic syndrome (also called syndrome X, insulin resistance syndrome, and obesity syndrome) is a multifactorial disease that refers to a number of risk factors that raise a person’s risk for heart disease, stroke, diabetes, fatty liver, and several cancers.
What Are Symptoms of Metabolic Syndrome?
Signs of metabolic syndrome include:
- Large waistline (abdominal obesity)
- High blood pressure (hypertension)
- High blood sugar (hyperglycemia)
- High blood levels of triglycerides (fats) (hypertriglyceridemia)
- Reduced high-density lipoprotein (HDL) cholesterol (the “good” cholesterol)
- Cardiovascular problems
- Chest pain
- Shortness of breath
- Dark skin discoloration in the body’s skin folds (acanthosis nigricans)
- Excess body hair
- Numbness and tingling of extremities
- Retina damage (in patients with insulin resistance and hyperglycemia or diabetes mellitus)
- Fatty growths under the skin (xanthomas or xanthelasmas) (in patients with very high levels of fats in the blood)
What Causes Metabolic Syndrome?
The cause of the metabolic syndrome is unknown but there are a number of risk factors, such as:
- Family history
- Poor diet
- Sedentary lifestyle
- Certain psychological characteristics, such as anger, depression, anxiety, and hostility
Contributing factors for metabolic syndrome include:
- Insulin resistance leading to obesity
- Cellular dysfunction by protein kinases and phosphatases
- Suppression of insulin receptor function
- Pancreatic dysfunction
- High triglycerides in the blood
- Oxidative stress on cells
- Chronic glucose toxicity
- Chronic systemic inflammation
- Disrupted sleep cycles and chronic fatigue
- Gut microbial imbalance
How Is Metabolic Syndrome Diagnosed?
Metabolic syndrome is diagnosed when a patient has at least 3 of the following 5 conditions:
- Fasting glucose 100 mg/dL or greater (or receiving drug therapy for hyperglycemia)
- Blood pressure 130/85 mm Hg or greater (or receiving drug therapy for hypertension)
- Triglycerides 150 mg/dL or greater (or receiving drug therapy for hypertriglyceridemia)
- HDL-C less than 40 mg/dL in men or less than 50 mg/dL in women (or receiving drug therapy for reduced HDL-C)
- Waist circumference 102 cm (40 in) or greater in men or 88 cm (35 in) or greater in women; OR 90 cm (35 in) or greater in men or 80 cm (32 in) in women or greater in Asian Americans
If patients meet the criteria for metabolic syndrome and also have complaints of chest pain, shortness of breath, or difficulty walking, additional tests for complications may include:
- Electrocardiography (rest/stress ECG)
- Ultrasonography (vascular, or rest/stress echocardiography)
- Stress single-photon emission computed tomography (SPECT) or cardiac positron emission tomography (PET)
- CT Angiogram of the heart
Other tests may be indicated for other causes or factors that can contribute to worsening symptoms, for example, sleep investigations for sleep-related breathing disorders, such as obstructive sleep apnea.
What Is the Treatment for Metabolic Syndrome?
- Following a low-fat heart-healthy diet
- Plant-based eating plans
- Exercising regularly
- Quitting smoking
- Managing stress
Medications used to treat high levels of fat in the blood (dyslipidemia) associated with metabolic syndrome include:
- Statins to reduce elevated LDL-C (“bad” cholesterol) levels
- Niacin to increase lowered HDL-C (“good” cholesterol) levels
- Niacin, fibrates, and omega-3 fatty acids to treat elevated triglyceride levels
- Insulin-sensitizing agents, such as metformin to treat high blood sugar (hyperglycemia)
Patients may also be prescribed a CPAP or BiPAP to treat obstructive sleep apnea if that condition is present.
What Are Complications of Metabolic Syndrome?
There are numerous complications of metabolic syndrome, including:
- Cardiovascular complications
- Nonalcoholic fatty liver disease
- Obstructive sleep apnea
- Certain cancers
- Pregnancy complications (preeclampsia)
- Accelerated cognitive aging