Metabolic Syndrome

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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 condition in which the body is unable to respond normally to insulin. 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.3

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, especially around your waist.
  • A history of diabetes during pregnancy (gestational diabetes).
  • Race and ethnicity. People with African, Hispanic, First Nations, Asian, and Pacific Islander backgrounds are at higher risk than whites for type 2 diabetes.1

How is metabolic syndrome diagnosed?

Your doctor can diagnose metabolic syndrome with a physical examination, 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: These criteria were developed by the American Heart Association. Other organizations may have different criteria for diagnosis.

Criteria for metabolic syndrome 2

Risk factor

Defining level

Abdominal obesity (waist measurement)

Men: Greater than 102 cm (40 in.)

Asian men: Greater than 91.5 cm (36 in.)

Women: Greater than 89 cm (35 in.)

Asian women: Greater than 81.5 cm (32 in.)

Triglycerides

1.7 mmol/L or higher, or taking medicine for high triglycerides

High-density lipoprotein (HDL) cholesterol

Men: Less than 1.0 mmol/L

Women: Less than 1.3 mmol/L

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

6.1 mmol/L 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, lower blood sugar levels, 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

Other Places To Get Help

Organizations

Canadian Diabetes Association
National Life Building
1400-522 University Avenue
Toronto, ON  M5G 2R5
Phone: (416) 363-0177
1-800-BANTING (1-800-226-8464)
Fax: (416) 408-7117
Email: info@diabetes.ca
Web Address: http://www.diabetes.ca
 

The Canadian Diabetes Association (CDA) is devoted to meeting the needs of people with diabetes in Canada. This organization provides general information about diabetes and its care. It organizes summer camps for young people with diabetes and conducts educational seminars to help people manage their diabetes. The CDA also sells a range of products, including cookbooks, in its stores.


Heart and Stroke Foundation of Canada
222 Queen Street
Suite 1402
Ottawa, ON  K1P 5V9
Phone: (613) 569-4361
Fax: (613) 569-3278
Web Address: www.heartandstroke.ca
 

The Heart and Stroke Foundation of Canada works to improve the health of Canadians by preventing and reducing disability and death from heart disease and stroke through research, health promotion, and advocacy.


References

Citations

  1. Canadian Diabetes Association (2008). Clinical practice guidelines for the prevention and management of diabetes in Canada. Available online: http://www.diabetes.ca/for-professionals/resources/2008-cpg.
  2. Grundy SM, et al. (2005). Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112(17): 2735–2752.
  3. Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486–2497.

Other Works Consulted

  • Brownlee M, et al. (2008). Complications of diabetes mellitus. In PR Larsen et al., eds., Williams Textbook of Endocrinology, 11th ed., pp. 1417–1498. Philadelphia: Saunders Elsevier.
  • Brunzell JD, Failor RA (2006). Diagnosis and treatment of dyslipidemia. In DC Dale, DD Federman, eds., ACP Medicine, section 9, chap. 6. New York: WebMD.
  • Buse JB, et al. (2008). Type 2 diabetes mellitus. In PR Larsen et al., eds., Williams Textbook of Endocrinology, 11th ed., pp. 1329–1381. Philadelphia: Saunders Elsevier.
  • Hawkins M, Rossetti L (2005). Insulin resistance and its role in the pathogenesis of type 2 diabetes. In Joslin's Diabetes Mellitus, 14th ed., pp. 425–448. Philadelphia: Lippincott Williams and Wilkins.
  • Masharani U, German MS (2007). Diabetic ketoacidosis section of Pancreatic hormones and diabetes mellitus. In DG Gardner et al., eds., Greenspan's Basic and Clinical Endocrinology, 8th ed., pp. 716–746. New York: McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Matthew I. Kim, MD - Endocrinology
Last Revised August 4, 2010

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