Metabolic Syndrome

Topic Overview

What is metabolic syndrome?

Metabolic syndrome is a group of health problems that include too much fat around the waist , elevated blood pressure, high triglycerides , elevated blood sugar, and low HDL cholesterol.

Together, this group of health problems increases your risk of heart attack, stroke, and diabetes.

What causes metabolic syndrome?

Metabolic syndrome is caused by an unhealthy lifestyle that includes eating too many calories, being inactive, and gaining weight, particularly around your waist . This lifestyle can lead to insulin resistance , a condition in which the body is unable to respond normally to insulin. If you have insulin resistance, your body cannot use insulin properly, and your blood sugar will begin to rise. Over time, this can lead to type 2 diabetes .

What are the symptoms?

If you have metabolic syndrome, you have several disorders of the metabolism at the same time, including obesity (usually around your waist), high blood pressure, low HDL cholesterol, and resistance to insulin.

Why is metabolic syndrome important?

This syndrome raises your risk for coronary artery disease (CAD), even beyond that caused by high LDL cholesterol alone. 2

What increases your chance of developing metabolic syndrome?

The things that make you more likely to develop metabolic syndrome include: 1, 2

  • Insulin resistance. This means that your body cannot use insulin properly.
  • Abdominal obesity. This means having too much fat around your waist.
  • Age. Your chances of developing metabolic syndrome increase as you get older.
  • Lack of exercise. If you do not exercise, you are more likely to be obese and develop metabolic syndrome.
  • Hormone imbalance. A hormone disorder such as polycystic ovary syndrome (PCOS), a condition in which the female body produces too much of certain hormones, is linked with metabolic syndrome.
  • Family history of type 2 diabetes. Having parents or close relatives with diabetes is associated with metabolic syndrome.
  • A history of diabetes during pregnancy ( gestational diabetes ).
  • Race and ethnicity. People with African, Hispanic, First Nations, Asian, and Pacific Islander backgrounds are at higher risk than whites for type 2 diabetes.

How is metabolic syndrome diagnosed?

Your doctor can diagnose metabolic syndrome with a physical examination, your medical history, and some simple blood tests.

You may be diagnosed with metabolic syndrome if you have three or more of the risk factors listed in the table below. Note: These criteria were developed by the National Heart, Lung, and Blood Institute. Other organizations may have different criteria for diagnosis.

Criteria for metabolic syndrome 1

Central obesity or abdominal obesity (waist measurement)

Defining level

People of European descent

Men: 94 cm or more; women: 80 cm or more

South Asians

Men: 90 cm or more; women: 80 cm or more

Chinese

Men: 90 cm or more; women: 80 cm or more

Japanese

Men: 90 cm or more; women: 80 cm or more

People of South and Central American descent

Men: 90 cm or more; women: 80 cm or more

First Nations

Men: 90 cm or more; women: 80 cm or more

People of African descent

Men: 94 cm or more; women: 80 cm or more

People of Eastern Mediterranean and Middle Eastern descent

Men: 94 cm or more; women: 80 cm or more

Plus two of the following

 

Triglycerides

Higher than 1.7 mmol/L

High-density lipoprotein (HDL) cholesterol

Men: Less than 1.03 mmol/L

Women: Less than 1.3 mmol/L

Blood pressure

Higher than 130/85 mm Hg or taking medicine for high blood pressure

Fasting blood sugar

Higher than 5.6 mmol/L

How is it treated?

The main goal of treatment is to reduce your risk of coronary artery disease (CAD) and diabetes. The first approaches in treating metabolic syndrome are:

  • Weight control. Being overweight is a major risk factor for CAD. Weight loss lowers LDL cholesterol and reduces all of the risk factors for metabolic syndrome.
  • Physical activity. Lack of exercise is a major risk factor for CAD. Regular exercise can help improve cholesterol levels. It can also lower blood pressure, reduce insulin resistance, lower blood sugar levels, and improve heart function.
  • Assessing risk category for CAD. After your risk is determined, treatment to lower LDL to appropriate levels can begin along with treatment of other metabolic risk factors, including high blood pressure and insulin resistance.

Other Places To Get Help

Organizations

Canadian Diabetes Association
www.diabetes.ca
Heart and Stroke Foundation of Canada
www.heartandstroke.com

References

Citations

  1. Genest J, et al. (2009). Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult—2009 recommendations. Canadian Journal of Cardiology, 25(10): 567–579.
  2. Grundy SM, et al. (2005). Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112(17): 2735–2752.

Other Works Consulted

  • Alberti K, et al. (2009). Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force of 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, 120(16): 1640–1645.
  • Brownlee M, et al. (2011). Complications of diabetes mellitus. In S Melmed et al., eds., Williams Textbook of Endocrinology, 12th ed., pp. 1462–1551. Philadelphia: Saunders.
  • Brunzell JD (2010). Diagnosis and treatment of dyslipidemia. In EG Nabel, ed., ACP Medicine, section 9, chap. 6. Hamilton, ON: BC Decker.
  • Eckel RH (2012). The metabolic sydrome. In DL Longo et al., eds., Harrison's Principals of Internal Medicine, 18th ed., vol. 2, pp. 1992–1997. New York: McGraw-Hill.
  • Hawkins M, Rossetti L (2005). Insulin resistance and its role in the pathogenesis of type 2 diabetes. In Joslin's Diabetes Mellitus, 14th ed., pp. 425–448. Philadelphia: Lippincott Williams and Wilkins.
  • Masharani U, German MS (2011). Pancreatic hormones and diabetes mellitus. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 9th ed., pp. 573–655. New York: McGraw-Hill.

Credits

ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Brian D. O'Brien, MD - Internal Medicine

Specialist Medical Reviewer Jennifer Hone, MD - Endocrinology, Diabetes and Metabolism

Current as ofNovember 14, 2014