Metabolic syndrome (also known as metabolic syndrome X) is a grouping of cardiac risk factors that result from insulin resistance (when the body's tissues do not respond normally to insulin). A person with metabolic syndrome has a greatly increased risk of cardiovascular disease and premature death.
The risk factors seen in metabolic syndrome include: insulin resistance, obesity (especially abdominal obesity), high blood pressure, abnormalities in blood clotting, and lipid abnormalities.
Specifically, metabolic syndrome is diagnosed if any three of the following are present:
Elevated waist circumference: 40 inches or more for men; 35 inches or more for women
Reduced HDL (“good”) cholesterol: less than 40 mg/dL in men; less than 50 mg/dL in women
Elevated blood pressure: 130/85 mm Hg or higher
Elevated fasting glucose: 100 mg/dL or higher
Why Are These Risk Factors Grouped Together in Metabolic Syndrome?
The primary problem in metabolic syndrome is insulin resistance. In the body's attempt to compensate for insulin resistance, extra insulin is produced, leading to elevated insulin levels. The elevated insulin levels can lead, directly or indirectly, to the characteristic metabolic abnormalities seen in these patients. Frequently, the insulin resistance will progress to overt type 2 diabetes, which further increases the risk of cardiovascular complications. In fact, another name for metabolic syndrome is pre-diabetes.
Who Gets Metabolic Syndrome?
Metabolic syndrome tends to run in families, along with the propensity for type 2 diabetes. Metabolic syndrome will occur in susceptible people who become overweight and sedentary. So, metabolic syndrome (like type 2 diabetes) can most often be prevented with exercise and maintaining a healthy body weight.
Anyone with a family history of type 2 diabetes who is overweight and sedentary should be evaluated for metabolic syndrome.
Treatment of Metabolic Syndrome
While there is no drug treatment that directly treats the underlying insulin resistance in metabolic syndrome, there is, in fact, a way to reverse insulin resistance--diet and exercise. Those with metabolic syndrome should make every attempt to reduce their body weight to within 20% of their "ideal" body weight (calculated for age and height). With vigorous efforts to reduce weight metabolic syndrome can be reversed and the risk for cardiovascular complications can be substantially improved.
However, human metabolism being what it is, many individuals with metabolic syndrome have trouble accomplishing these goals. In these cases, each associated risk factor needs to be treated individually and aggressively.
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