Hospital Affiliation
Metabolic Syndrome
(Syndrome X; Insulin Resistance Syndrome; Dysmetabolic Syndrome)
Definition
- Central obesity—high amount of fat around the waist
- Low levels of high density lipoprotein (HDL) cholesterol
- High levels of triglycerides—type of fat measured in the blood
- Elevated blood pressure
- Elevated fasting blood sugar
| Coronary Heart Disease |
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Causes
- Genetic factors
- Central obesity
- Lack of physical activity
- Poor diet
Risk Factors
- Ethnicity—Mexican American women, Caucasians, and African Americans.
- Obesity
- Having disorders or conditions associated with metabolic disorder such as:
- Diabetes
- High blood pressure
- Cholesterol problems
- Coronary artery disease
- Polycystic ovary syndrome
- Genes—Having a family history of the disorders listed above
- Physical inactivity
- Poor diet
- Unhealthy habits, such as smoking
- Certain medication, such as atypical antipsychotics
Diagnosis
- Waist measurement—greater than 40 inches in Caucasian men (35 inches in Asian men) or 35 inches in Caucasian women (30 inches in Asian women)
- Fasting glucose level—greater than or equal to 100 mg/dL* (5.55 mmol/L)
- Triglyceride level—greater than or equal to 150 mg/dL (1.7 mmol/L)
- HDL cholesterol—less than 40 mg/dL (1.0 mmol/L) in men and less than 50 mg/dL (1.3 mmol/L) in women
- Blood pressure—greater than or equal to 130/85 millimeters of mercury (mm Hg)
Treatment
- Treatment of underlying causes
- Treatment of specific metabolic abnormality
Treatment of Underlying Causes
- Reducing excess weight by at least 10% in the next 6-12 months
- Increasing physical activity to 30-60 minutes of moderate aerobic exercise four or more days per week as approved by your doctor
- Lowering blood pressure to below 130/85 mmHg with diet, exercise, and possibly medication
- Improving triglyceride and HDL cholesterol levels through diet, exercise, and possibly medication
Treatment of Specific Metabolic Abnormality
- High blood pressure—treated with anti-hypertensive medication and lifestyle changes
- Insulin resistance—treated with diabetes medications and lifestyle changes
- High cholesterol—treated with cholesterol-lowering medications called statins and lifestyle changes
- Clotting tendency—treated with low-dose aspirin, especially in those with moderate to high cardiovascular risk
Prevention
- If you smoke, talk to your doctor about how to quit.
- Achieve and maintain a healthy weight by eating fruits, vegetables, and whole grains.
- Work up to 30 minutes of moderate aerobic exercise at least four days per week.
- Drink alcohol in moderation. This means no more than two drinks daily for men, one drink daily for women.
RESOURCES
American Heart Association http://www.heart.org
National Institute of Diabetes & Digestive & Kidney Diseases http://www.niddk.nih.gov
CANADIAN RESOURCES
Canadian Cardiovascular Society http://www.ccs.ca
Canadian Diabetes Association http://www.diabetes.ca
References
Batsis JA, Romero-Corral A, Collazo-Clavell ML, et al. Effect of bariatric surgery on the metabolic syndrome: a population-based, long-term controlled study. Mayo Clin Proc. 2008 Aug;83(8):897-907.
Deen D. Metabolic syndrome: time for action. Am Fam Physician. 2004;69:2875-2882.
Gami AS, Witt BJ, Howard DE, et al. Metabolic syndrome and risk of incident cardiovascular events and death. J Am Coll Cardiol. 2007;49:403-414.
Grundy SM, Brewer HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the NHLBI/AHA conference on scientific issues related to definition. Circulation. 2004;109:433-438.
Grundy SM, Cleeman JI, Diniels SR, et al. AHA/NHLBI Diagnosis and management of the metabolic syndrome: an AHA/NHLBI Scientific Statement. Circulation. 2005;112:2735-2752.
Metabolic syndrome. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MetabolicSyndrome/Metabolic-Syndrome%5FUCM%5F002080%5FSubHomePage.jsp. Accessed May 14, 2013.
Metabolic syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 29, 2013. Accessed May 14, 2013.
What is metabolic syndrome? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/ms/. Updated November 3, 2011. Accessed May 14, 2013.
Wright JT, Harris-Haywood S, Pressel S, et al. Clinical outcomes by race in hypertensive patients with and without the metabolic syndrome (ALLHAT). Arch Int Med. 2008;168:207-217.
1/13/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Salas-Salvadó J, Fernández-Ballart J, Ros E, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med. 2008;168:2449-2458.
2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Davidson LE, Hudson R, Kilpatrick K, et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med. 2009;169:122-131.
5/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2009;32:688-694.