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.¹

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. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are at higher risk than whites for type 2 diabetes.³

How is metabolic syndrome diagnosed?

Your doctor can diagnose metabolic syndrome with a physical exam, 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.

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

Related Information

• Coronary Artery Disease
• Healthy Eating for Children
• High Blood Pressure (Hypertension)
• High Cholesterol
• High Triglycerides
• Obesity
• Type 2 Diabetes
• Weight Management

References

Citations

1. Grundy SM (2001). United States cholesterol guidelines 2001: Expanded scope of intensive low-density lipoprotein-lowering therapy. American Journal of Cardiology, 88(7B): 23J–27J.
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. American Diabetes Association (2004). Screening for type 2 diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S11–S14.

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). 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.

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