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What Is Metabolic Syndrome?

Metabolic Syndrome: Symptoms and Causes

Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.

Metabolic syndrome is a collection of disorders that occur together and increase your risk of developing type 2 diabetes or cardiovascular disease (stroke or heart disease). The causes of metabolic syndrome are complex and not well understood, but there is thought to be a genetic link. Being overweight or obese and physically inactive adds to your risk. Metabolic syndrome is sometimes called syndrome X or insulin-resistance syndrome.

Metabolic syndrome (MetS) is a complex disorder with high socioeconomic cost that is considered a worldwide epidemic. MetS is defined by a cluster of interconnected factors that directly increase the risk of coronary heart disease (CHD), other forms of cardiovascular atherosclerotic diseases (CVD), and diabetes mellitus type 2 (DMT2).

Its main components are dyslipidemia (elevated triglycerides and apolipoprotein B (apoB)-containing lipoproteins, and low high-density lipoproteins (HDL)), elevation of arterial blood pressure (BP) and dysregulated glucose homeostasis, while abdominal obesity and/or insulin resistance (IR) have gained increasing attention as the core manifestations of the syndrome.

Recently, other abnormalities such as chronic proinflammatory and prothrombotic states, non-alcoholic fatty liver disease and sleep apnea have been added to the entity of to the syndrome, making its definition even more complex. Besides the many components and clinical implications of MetS, there is still no universally accepted pathogenic mechanism or clearly defined diagnostic criteria. Furthermore, there is still debate as to whether this entity represents a specific syndrome or is a surrogate of combined risk factors that put the individual at particular risk.

A main evolving aspect of MetS is its increasing prevalence in both childhood and young adulthood and the future implications to the global health burden this may confer. In the present work we discuss the importance of establishing clear criteria to define MetS, highlighting the latest research, which we use to provide a critical review of currently existing controversies in this field and expand on the childhood and adulthood aspect of the syndrome.

As we get older, we tend to become less active and may gain excess weight. This weight is generally stored around the abdomen, which can lead to the body becoming resistant to the hormone insulin. This means that insulin in the body is less effective, especially in the muscles and liver.

Having just one of these conditions doesn’t mean you have metabolic syndrome. But it does mean you have a greater risk of serious disease. And if you develop more of these conditions, your risk of complications, such as type 2 diabetes and heart disease, rises even higher.

What Is Metabolic Syndrome?

Metabolic syndrome is a health condition that everyone’s talking about.

Although the first formal definition of metabolic syndrome entered medical textbooks not so long ago (1998), it is as widespread as pimples and the common cold. According to the American Heart Association, 47 million Americans have it. That’s almost a staggering one out of every six people. The syndrome runs in families and is more common among African-Americans, Hispanics, Asians, and Native Americans. The risks of developing metabolic syndrome increases as you age.

Indeed, metabolic syndrome seems to be a condition that many people have, but no one knows very much about. It’s also debated by the experts — not all doctors agree that metabolic syndrome should be viewed as a distinct condition.

So what is this mysterious syndrome — which also goes by the scary-sounding name Syndrome X — and should you be worried about it?

Understanding Metabolic Syndrome

Metabolic syndrome is not a disease in itself. Instead, it’s a group of risk factors — high blood pressure, high blood sugar, unhealthy cholesterol levels, and abdominal fat.

Obviously, having any one of these risk factors isn’t good. But when they’re combined, they set the stage for serious problems. These risk factors double your risk of blood vessel and heart disease, which can lead to heart attacks and strokes. They increase your risk of diabetes by five times.

The good news is that metabolic syndrome can be controlled, largely with changes to your lifestyle.

What Causes Metabolic Syndrome?

Experts don’t fully understand what causes metabolic syndrome. Several factors are interconnected. Obesity plus a sedentary lifestyle contributes to risk factors for metabolic syndrome. These include high cholesterol, insulin resistance, and high blood pressure. These risk factors may lead to cardiovascular disease and type 2 diabetes.

Because metabolic syndrome and insulin resistance are closely tied, many healthcare providers believe that insulin resistance may be a cause of metabolic syndrome. But they have not found a direct link between the two conditions. Others believe that hormone changes caused by chronic stress lead to abdominal obesity, insulin resistance, and higher blood lipids (triglycerides and cholesterol).

Other factors that may contribute to metabolic syndrome include genetic changes in a person’s ability to break down fats (lipids) in the blood, older age, and problems in how body fat is distributed.

Are You at Risk for Metabolic Syndrome

Given how common metabolic syndrome is — it’s estimated that one out of four people meet the criteria — everyone should be worried about their risk factors. After all, metabolic syndrome can dramatically increase your risk of serious health problems, such as diabetes, heart attacks, and strokes — yet often people don’t even know what it is.

Metabolic syndrome is generally defined as a cluster of risk factors, including high blood sugar, extra abdominal fat, high blood pressure, and unhealthy cholesterol levels.

Some of these risk factors you can control. Others are outside your control. But if you understand the entire range of risk factors, you can better protect your health. You may have a higher risk of metabolic syndrome if:

  • You are older. It’s more common as people age. The risk of getting metabolic syndrome rises from 20% in your 40s, to 35% in your 50s, to 45% in your 60s and beyond.
  • You are prone to blood clots and inflammation. Both are common in people with metabolic syndrome. Your doctor can do blood tests to find out if you have a high risk of clots and inflammation.
  • You have other medical conditions. Metabolic syndrome is associated with a number of medical conditions. These include polycystic ovary syndrome (PCOS), fatty liver, cholesterol gallstones, and lipodystrophy (which affects fat distribution).
  • It runs in the family. Even if you are not obese you may have inherited a higher risk. This includes people who have parents or other first-degree relatives with diabetes.
  • You are South Asian. South Asians seem to have a higher risk of insulin resistance and thus metabolic syndrome. Because of this, the American Heart Association and the National Heart, Lung, and Blood Institute have different recommendations for this group. A waist size above 35″ (for men) and 31″ (for women) is considered a metabolic syndrome risk factor.

Symptoms of Metabolic Syndrome

The complications that may result from metabolic syndrome are frequently serious and long-term (chronic). They include:

  • hardening of the arteries (atherosclerosis)
  • diabetes
  • heart attack
  • kidney disease
  • stroke
  • nonalcoholic fatty liver disease
  • peripheral artery disease
  • cardiovascular disease

If diabetes develops, you may be at risk for additional health complications, including:

  • eye damage (retinopathy)
  • nerve damage (neuropathy)
  • kidney disease
  • amputation of limbs

How Is Metabolic Syndrome Diagnosed?

Expert organizations have developed criteria to diagnose metabolic syndrome. Criteria include:

  • Abdominal obesity
  • BMI above 25
  • High triglycerides
  • Low HDL cholesterol
  • High blood pressure or using medicine to lower blood pressure
  • High fasting blood glucose
  • Increased blood clotting. This means you have more plasma plasminogen activator and fibrinogen, which cause blood to clot.
  • Insulin resistance. This means you have type 2 diabetes, impaired fasting glucose, or impaired glucose tolerance. The impaired glucose tolerance test measures the body’s response to sugar.

Each organization has its own guidelines for using the above criteria to diagnose metabolic syndrome.

How Do You Treat Metabolic Syndrome?

Metabolic syndrome is a group of risk factors that include abdominal fat, high blood pressure, high blood sugar, and unhealthy cholesterol levels. Treatment is focused on tackling each of these conditions. The goal is to cut your odds of blood vessel disease and heart disease, as well as diabetes.

In most cases, the best treatment for metabolic syndrome rests with you. Changes to your behavior — such as eating healthier and getting more exercise — are the first things your doctor will suggest. By adopting some healthy habits, you may be able to eliminate your risk factors completely

Make These Lifestyle Changes

  • Get some exercise. Exercise is a great way to lose weight, but don’t get down if the scale isn’t showing progress. Even if you don’t lose a single pound, exercise can lower blood pressure, improve cholesterol levels, and improve insulin resistance. If you’re out of shape, start slowly. Try walking more. Work more physical activity into your day. When you’re on foot, allow a little extra time to take the scenic route to get some extra steps. To keep track, buy a pedometer (step counter). Gradually increase your physical activity until you’re doing it on most days of the week. But don’t get too ambitious. If you try a workout regime that’s too tough, you may give up. You need to find a level of exercise that fits your personality.
  • Eat a healthy diet. Eating a healthy diet can improve your cholesterol, insulin resistance, and blood pressure — even if your weight stays the same. For advice on healthy eating, ask your doctor or registered dietitian. If you have heart disease or diabetes, you may need special meal plans. In general, a diet that’s low in saturated fats, trans fat, cholesterol, and salt — and high in fruits, vegetables, lean protein, beans, low fat dairy, and whole grains — has been shown to help people with high blood pressure and a higher risk of cardiovascular disease. Many doctors suggest a “Mediterranean” diet or the DASH diet. These meal plans emphasize “good” fats (like the monounsaturated fat in olive oil) and a balance of carbohydrates and proteins.
  • Lose some weight. Obviously, weight loss is often a by-product of exercising and eating well. But it’s a key goal in itself if you’re overweight or obese. Weight loss can improve every aspect of metabolic syndrome.
  • If you smoke, quit. It’s not a risk factor for what’s considered metabolic syndrome, yet smoking greatly increases your risk of blood vessel and heart disease.

f you are diagnosed with metabolic syndrome, the goal of treatment will be to reduce your risk of developing further health complications. Your doctor will recommend lifestyle changes that may include losing between 7 and 10 percent of your current weight and getting at least 30 minutes of moderate to intense exercise five to seven days a week. They may also suggest that you quit smoking.

Your doctor may prescribe medications to reduce your blood pressure, cholesterol, and/or blood sugar. They may also prescribe low-dose aspirin to help reduce your risk of stroke and heart attack.

How Can You Prevent Metabolic Syndrome?

Metabolic syndrome is a group of risk factors: high blood pressure, high blood sugar, unhealthy cholesterol levels, and excess fat in the abdomen. Having these risk factors drastically raises your risk of diabetes, and blood vessel and heart disease.

Experts say you can prevent metabolic syndrome in the same way you would treat it. You need to make sensible changes to your lifestyle. You should:

  • Exercise. Start slowly. The American Heart Association recommends, if possible, that you gradually step up to exercising on most days of the week for 30-60 minutes. Consult your health care provider if you have any physical limitations or concerns.
  • Eat a healthy diet with fruits and vegetables, lean protein, whole grains, and low fat dairy, and go easy on the saturated fats, trans fat, cholesterol, and salt.
  • Lose weight if you’re overweight.
  • Quit smoking if you smoke — now.
  • Schedule regular checkups with your doctor. Since metabolic syndrome doesn’t have symptoms, you need regular doctor visits to check your blood pressure, cholesterol, and blood sugar.

Preventing metabolic syndrome is certainly possible. Maintaining a healthy waist circumference and blood pressure and cholesterol levels reduce your risk for metabolic syndrome. Exercise and weight loss can aid in these efforts and decrease insulin resistance.

In particular, eat a healthy diet that includes fruits, vegetables, and whole grains. Exercise is also important when it comes to preventing this condition. Regular physical activity will reduce your blood pressure, blood sugar, and cholesterol levels. The key is to try to maintain a healthy weight. Talk to your doctor before beginning an exercise program or radically changing your diet.

Prevention of metabolic syndrome will also require that you have regular physical exams. Your doctor can measure your blood pressure and complete blood work that may indicate the early development of metabolic syndrome. Early diagnosis of the condition and treatment will reduce health complications over the long term.

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