Metabolic Syndrome
What is the metabolic syndrome?
The metabolic syndrome is characterized by a group of metabolic risk factors in one person. They include:
- Central obesity: excessive fat tissue in and around the abdomen.
- Abnormal fats in the blood: Blood-fat disorders, such as high triglycerides and low HDL cholesterol, foster plaque buildups in arterial walls.
- Elevated blood pressure (130/85 mmHg or higher)
- Insulin resistance, or glucose intolerance: The body can't properly use insulin or blood sugar. This will develop into overt diabetes if the condition remains untreated.
- Pro-thrombotic state: This is a tendency to form clots resulting in stroke, heart attack, or other vascular problems.
The underlying causes of this syndrome are overweight/obesity, physical inactivity, and genetic factors. People with the metabolic syndrome are at increased risk of coronary heart disease, (heart attacks), other diseases related to plaque buildups in artery walls (such as stroke and peripheral vascular disease), and type 2 diabetes.
Who has the metabolic syndrome?
The metabolic syndrome is becoming increasingly common in the United States. As many as 47 million U.S. adults may currently have it, and many of them are unaware that they do.
The syndrome is closely associated with a disorder called insulin resistance, in which the body is unable to use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.
Some people are genetically predisposed to insulin resistance. However, it is the acquired factors, such as excess body fat and physical inactivity, which ultimately elicits insulin resistance and results in the metabolic syndrome. Most people with insulin resistance have central obesity, meaning they have a tendency to gain their weight in their midsection. The biologic mechanisms at the molecular level between insulin resistance and metabolic risk factors aren't fully understood and appear to be complex.
How is the metabolic syndrome diagnosed?
It is not easy to diagnose, but currently the metabolic syndrome is identified by the presence of three or more of the following components:
Central Obesity as measured by waist size:
- Men: Greater than 40 inches
- Women: Greater than 35 inches
Elevated Fasting Blood Triglycerides
- greater than or equal to 150 mg/dL
Low HDL cholesterol
- Men: Less than 40 mg/dL
- Women: Less than 50 mg/dL
Elevated Blood Pressure
- greater than or equal to 130/85 mmHg
Elevated Fasting Glucose
- greater than or equal to 110 mg/dL
American Heart Association (AHA) Recommendation
More studies are needed to understand the relationship between metabolic risk factors and the efficacy of drug therapy in people who have the metabolic syndrome.
To gain the most benefit from modifying multiple metabolic risk factors, the underlying insulin resistant state must become a target of therapy.
The safest, most effective and preferred way to reduce insulin resistance is through weight loss (if overweight) and increased physical activity. This is the bottom line regardless of any medical therapy!
Other steps for managing the metabolic syndrome are also important for patients and their doctors:
- Routinely monitor body weight (especially the index for central obesity), blood glucose, lipids, and blood pressure.
- Treat individual risk factors (abnormally high fats in the blood, high blood pressure, and high blood sugar) according to established guidelines.
Your data
BP: ___________
Body Mass Index: ______
Height: ______
Weight: _______ lbs
Total Cholesterol: ______
HDL cholesterol: ______
Triglycerides: ______
Fasting glucose: ______