Metabolic Syndrome

Introduction

Metabolic syndrome is a term used to describe the combined effects of several conditions that increase the risk of heart disease, stroke, and diabetes.  The conditions include high blood pressure, resistance to insulin, abnormal cholesterol and triglyceride levels, and obesity with excess body fat around the waist.  Metabolic syndrome, formerly referred to as Syndrome X and insulin resistance syndrome, is on the rise in the United States.  Lifestyle changes and medications can help delay or prevent the development of serious medical conditions.

Anatomy

Insulin resistance is a condition in which the body does not recognize or respond to the insulin in the bloodstream.  Insulin allows blood sugar (glucose) to enter body cells where it is used as energy.  Insulin resistance causes elevated blood glucose levels because the glucose cannot get into the body cells and remains in the bloodstream.

Causes

Metabolic syndrome describes several conditions that occur at the same time.  The combination of conditions increases the risk of heart disease, stroke, and diabetes.  The conditions include high blood pressure, elevated insulin levels and resistance to insulin, abnormal cholesterol and triglyceride levels, and obesity with excess body fat around the waist.  The exact cause of metabolic syndrome is unknown.  Researchers believe that insulin resistance is the underlying cause.  Researchers are not sure what causes insulin resistance, but it may be a combination of inherited and environmental factors.  Lifestyle factors such as being overweight or inactive contribute to the condition.

Symptoms

Metabolic syndrome means that you have several disorders at the same time, including high blood pressure; obesity, with fat accumulation around the waist; high triglycerides and low HDL cholesterol; and insulin resistance with higher than normal blood sugar levels.  Having one or more condition increases your risk of developing metabolic syndrome.  The more contributing conditions that you have, the greater risk you have for heart disease, stroke, and diabetes.

Diagnosis

If you have at least one component of metabolic syndrome, ask your doctor to check for the other conditions.  Blood pressure, cholesterol, triglyceride, weight, and insulin evaluations can all be performed in your doctor’s office.  A diagnosis of metabolic syndrome requires three of the following conditions to be present:  obesity with body fat on the waist, elevated triglycerides, reduced HDL cholesterol, high blood pressure, an elevated fasting blood sugar, or you are already receiving treatment for high blood sugar.

Treatment

Lifestyle changes and medication can help improve all of the metabolic syndrome components.  It is helpful to exercise regularly and lose weight.  Even losing as little as 5% to 10% of your total body weight can lower your blood sugar levels and blood pressure.  You may ask your doctor to refer you to a nutritionist that can help you with meal planning and healthy food choices.  Stop smoking.  Smoking contributes to high blood pressure and increases insulin resistance.  There are many smoking products and resources that your doctor can recommend to help you quit smoking.

Attend all of your appointments to help your doctor monitor your condition.  If lifestyle changes alone do not resolve your conditions, medications may help.  Your doctor can prescribe medications for cholesterol, triglycerides, high blood pressure, high blood sugar, and weight loss.  Ask your doctor if aspirin therapy to prevent heart attack and stroke is right for you. 

Prevention

You may prevent metabolic syndrome by reducing the risk factors that you can control with lifestyle changes, including not smoking, weight reduction, regular exercise, and healthy eating. Take your medications as directed by your doctor, and attend all of your follow-up appointments.

Am I at Risk

 Increasing age is associated with metabolic syndrome, although it is becoming more predominant in school age children.
_____ People that are Hispanic or Asian have a greater risk than people of other races do.
_____ Obesity is a risk factor for metabolic syndrome. Abdominal obesity, weight around the waist or an “apple shaped” body presents a greater risk.
_____ A family history of diabetes or diabetes during pregnancy (gestational diabetes) increases the risk of metabolic syndrome.
_____ High blood pressure increases the risk of metabolic syndrome.
_____ Polycystic ovary disease in women alters hormones and increases the risk.
_____   People with heart disease have an increased risk of developing metabolic syndrome.

Complications

Metabolic syndrome can lead to heart attack, stroke, and diabetes.  Not only can these conditions reduce your activity level and quality of life, but they can also cause death.