Metabolic syndrome is a collection of factors that place an individual at a higher risk of a number of cardiovascular and metabolic diseases. Also known as syndrome X or insulin resistance syndrome, metabolic syndrome was first described and defined as a syndrome in 1998 by the World Health Organization. A recent estimation by the American Heart Association indicated that about 25% of American adults are likely to be affected by metabolic syndrome.
The exact etiology of metabolic syndrome has not been conclusively identified. However, some possible etiological conditions that could contribute to the development of metabolic syndrome have been identified as obesity, other adipose tissue disorders, insulin resistance, simultaneous flaws in multiple metabolic regulatory pathways, proinflammatory states, and various hormones. A number of risk factors that predict the likelihood of developing metabolic syndrome have also been determined, including a sedentary lifestyle, smoking, aging, and family history due to both familial environments and genetic factors.
A diagnosis of metabolic syndrome indicates that an individual has a significantly elevated risk of developing a number of severe diseases, with the primary negative outcome identified as cardiovascular disease (CVD). Metabolic syndrome can also indicate an increase in an individual’s risk for type II diabetes, obesity, coronary heart disease, atherosclerosis, arrhythmias, myocardial infarction (heart attack), heart failure, strokes, and other related diseases or disorders.
Several specific symptoms are used to define whether a person has metabolic syndrome, as well as the elevated risks for other diseases that are associated with the syndrome. An individual must have at least three of the following to be diagnosed with metabolic syndrome:
- High waist circumference (> 40 inches in men, > 35 inches in women)
- High body mass index (> 30 on the standard BMI scale)
- High fasting triglycerides (> 150 mg per dL of blood [mg/dL])
- Low high-density lipoprotein (< 40 mg/dL in men, < 50 mg/dL in women)
- Hyperinsulinemia (> 25 µU/mL)
- Fasting hyperglycemia (> 100 mg/dL)
- High systolic blood pressure (> 130 mm Hg)
- High diastolic blood pressure (> 85 mm Hg)
A physician most often diagnoses metabolic syndrome using a laboratory workup in order to accurately identify the presence of at least three of the above criteria. A diagnosis of metabolic disorder is primarily a call to action in terms of instituting lifestyle changes immediately. The syndrome indicates a risk for many debilitating and life-threatening conditions, but these conditions develop over years of poor health. Therefore, there is still enough time to prevent further damage through treatment and immediate lifestyle changes.
There is no standardized treatment regimen for metabolic syndrome so far, specifically because the underlying etiology is not fully understood yet. However, there are many lifestyle changes that are regularly initiated for individuals who have been diagnosed with the syndrome. These lifestyle changes can include:
- 30-60 minutes of exercise several days per week
- Adopting a low-fat and low-sodium diet
- Losing excess weight (in a healthy manner)
- Quitting smoking
- Some medications (i.e. Angiotensin-Converting Enzyme (ACE) Inhibitors or Beta Blockers to manage high blood pressure)
Most of these changes are targeted at the individual risk factors that compose the syndrome, as opposed to targeting the underlying causes of the syndrome. Once the causes of the syndrome are more clearly identified, a major future healthcare goal will be to design treatments that can correct those underlying causes.
American Academy of Family Physicians
American Diabetes Association
American Heart Association
National Institute of Health