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Metabolic syndrome

Insulin resistance syndrome; Syndrome X

 

Metabolic syndrome is a name for a group of risk factors that occur together and increase the chance of having coronary artery disease, stroke, and type 2 diabetes.

Causes

 

Metabolic syndrome is becoming very common in the United States. Doctors are not sure whether the syndrome is due to one single cause. But many of the risks for the syndrome are related to obesity.

The two most important risk factors for metabolic syndrome are:

  • Extra weight around the middle and upper parts of the body (central obesity). This body type may be described as "apple-shaped."
  • Insulin resistance. Insulin is a hormone produced in the pancreas. Insulin is needed to help control the amount of sugar in the blood. Insulin resistance means that some cells in the body use insulin less effectively than normal. As a result, blood sugar level rises, which causes insulin to rise. This may increase the amount of body fat.

Other risk factors include:

  • Aging
  • Genes that make you more likely to develop this condition
  • Changes in male, female, and stress hormones
  • Lack of exercise

People who have metabolic syndrome often have one or more other factors that may be linked with the condition, including:

  • Increased risk for blood clotting
  • Increased levels of blood substances that are a sign of inflammation throughout the body
  • Small amounts of a protein called albumin in the urine

 

Exams and Tests

 

Metabolic syndrome is present if you have three or more of the following signs:

  • Blood pressure equal to or higher than 130/85 mm Hg
  • Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
  • Large waist circumference (length around the waist): For men, 40 inches (100 centimeters) or more; for women, 35 inches (90 centimeters) or more
  • Low HDL (good) cholesterol: For men, less than 40 mg/dL; for women, less than 50 mg/dL
  • Triglycerides equal to or higher than 150 mg/dL

 

Treatment

 

The goal of treatment is to reduce your risk for heart disease, stroke, and diabetes.

Your health care provider will recommend lifestyle changes or medicines:

  • Lose weight. The goal is to lose between 7% and 10% of your current weight. You will probably need to eat 500 to 1,000 fewer calories per day.
  • Get 150 minutes a week of moderate intensity exercise such as walking. Do exercises to strengthen your muscles 2 days a week.
  • Lower your cholesterol by eating healthier foods, losing weight, exercising, and taking cholesterol-lowering medicines, if needed.
  • Lower your blood pressure by eating less salt, losing weight, exercising, and taking medicine, if needed.

Your provider may recommend daily low-dose aspirin.

If you smoke, now is the time to quit.

 

Outlook (Prognosis)

 

People with metabolic syndrome have an increased long-term risk of developing heart disease, type 2 diabetes, stroke, kidney disease, and poor blood supply to the legs.

 

When to Contact a Medical Professional

 

Call your provider if you have signs or symptoms of this condition.

 

 

References

Centers for Disease Control and Prevention. Physical activity basics. Updated June 4, 2015. www.cdc.gov/physicalactivity/basics. Accessed June 29, 2016.

Raynor HA, Champagne CM. Position of the Academy of Nutrition and Dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016;116(1):129-147. PMID: 26718656. www.ncbi.nlm.nih.gov/pubmed/26718656.

Ruderman NB, Shulman GI. Metabolic syndrome. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 43.

 

        A Closer Look

         

          Talking to your MD

           

            Self Care

             

              Tests for Metabolic syndrome

               

                 

                Review Date: 5/17/2016

                Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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