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 problem with the body's metabolism. 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, high cholesterol levels, and resistance to insulin.

Why is metabolic syndrome important?

Research has shown that having this syndrome increases your risk for coronary artery disease (CAD), even beyond that caused by high LDL cholesterol alone.¹

What increases your chance of developing metabolic syndrome?

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

• Insulin resistance. Insulin resistance means that your body cannot use insulin properly.
• Abdominal obesity. Having too much fat around your waist is another major risk factor.
• 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 associated with metabolic syndrome.
• Family history of type 2 diabetes. Having parents or close relatives with diabetes is associated with metabolic syndrome.
• Weight gain due to eating foods that have bad fats (saturated and trans fats), and sugar.

How is metabolic syndrome diagnosed?

Your health professional can diagnose metabolic syndrome with a physical exam, 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 that other organizations may have different criteria for diagnosis.

Criteria for metabolic syndrome²

Risk factor	Defining level
Abdominal obesity (waist measurement)	Men: Greater than 40 in. (101.6 cm) Women: Greater than 35 in. (88.9 cm)
Triglycerides	150 mg/dL or higher, or taking medicine for high triglycerides
High-density lipoprotein (HDL) cholesterol	Men: Less than 40 mg/dL Women: Less than 50 mg/dL Or taking medicine for low HDL cholesterol
Blood pressure	130/85 mm Hg or higher, or taking medicine for high blood pressure
Fasting blood sugar	100 mg/dL or higher, or taking medicine for high blood sugar

How is metabolic syndrome treated?

The main goal of treatment for metabolic syndrome 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 physical activity reduces very low-density lipoprotein (VLDL) levels, raises HDL cholesterol and, in some people, lowers LDL levels. It can also lower blood pressure, reduce insulin resistance, 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.¹

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Author:	Ralph Poore	Last Updated: July 20, 2006
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine Neil J. Stone, MD, FACC, FACP - Internal Medicine, Cardiology
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