Metabolic Syndrome

Primary care physician Bharat K. Shah, MD, board certified in Internal Medicine, answers questions about Metabolic Syndrome.

Disclaimer: This is not intended to be medical advice. Please consult your physician for more information.

Q. What is Metabolic Syndrome?

A. The "metabolic syndrome" (sometimes called cardiometabolic syndrome, insulin resistance syndrome, or syndrome X) is a collection of "cardiovascular risk factors" that can increase your risk of developing heart disease, stroke, and diabetes. More than one in five Americans has metabolic syndrome. The number of people with this syndrome increases with age, affecting more than 40% of people in their 60s and 70s.

Q. What are these health risks?

• Abdominal obesity - increased belly fat! Also called "central obesity." This is defined by a waistline of 40 inches or more for men and 35 inches or more for women (measured across the belly at the widest point.)
• Elevated blood pressure - a blood pressure reading of 130/85 mm Hg or higher or on blood pressure medications.
• High cholesterol and other blood fats - This is called "dyslipidemia" by physicians. People who have this often show a fasting triglyceride level above 150 mg/dL and a level of the "good cholesterol" (the high-density lipoprotein or HDL) less than 40 mg/dL (men) and under 50 mg/dL (women).
• High glucose (blood sugar) levels - a fasting blood glucose level greater than 100 mg/dL, or already diagnosed with diabetes and on glucose-lowering medications.

Q. Who typically has Metabolic Syndrome?

A. Usually, there are no immediate physical symptoms. One physical sign is "acanthosis nigricans," a feeling you can't get your neck or underarms clean after bathing. Medical problems associated with the metabolic syndrome develop slowly. If you are unsure if you have metabolic syndrome, see your health care provider. He or she will be able to make the diagnosis by obtaining the necessary tests, including blood pressure, lipid profile (triglycerides and HDL), and blood sugar.

Q. What causes Metabolic Syndrome?

A. The exact cause of metabolic syndrome is not known. Many features of the metabolic syndrome are associated with "insulin resistance." Insulin resistance means that the body does not use insulin efficiently to lower glucose and triglyceride levels. Insulin resistance results from a combination of genetic and lifestyle factors. You need to do something to reduce your insulin resistance. Lifestyle factors include making healthier food choices, increasing physical activity, and improving your sleep pattern.

Q. If I have Metabolic Syndrome, what health problems might develop?

A. The metabolic syndrome, the insulin resistance that goes with it, and the higher than normal glucose levels that result, can be linked to many harmful changes to the body including:

• Damage to the lining of coronary and other arteries, a key step toward the development of heart disease or stroke.
• Changes in the kidneys' ability to remove salt, leading to high blood pressure, heart disease, and stroke.
• An increase in triglyceride levels, resulting in an increased risk of developing cardiovascular disease.
• An increased risk of blood-clot formation, which can cause heart attacks and strokes.
• The body's inability to produce enough insulin to overcome the insulin resistance resulting in Type 2 diabetes. Type 2 diabetes increases your risk for a heart attack and stroke and may damage your eyes, nerves, and kidneys.

Q. How do I prevent or reverse Metabolic Syndrome?

A. Lifestyle!!!!! Since physical inactivity and excess weight are the main things that you can control, getting more exercise and losing weight can help reduce or prevent the complications associated with this condition. Be sure to talk to your doctor about how much and what kind of exercise would be right for you. Talk to a registered dietitian about adjusting your eating plan to help maintain good health. Your doctor may also prescribe medications to manage some of the other conditions that are part of the metabolic syndrome, such as high cholesterol, high glucose, and high blood pressure. You need to commit to consistently taking these medications even when you feel fine.

Alcohol intake. Limiting alcohol intake can also help reduce your risk of developing the metabolic syndrome. As long as your doctor has not told you that you cannot consume ANY alcoholic beverages, consume no more than one drink a day for women or two drinks for men.

References from: American Diabetes Association, Josilin Diabetes Center, Cleveland Clinic, and American Heart Association