Metabolic Syndrome
En Español (Spanish Version)
More InDepth Information on This Condition

Definition
Metabolic syndrome is a group of risk factors for cardiovascular disease. Metabolic syndrome puts a person at risk for:

Metabolic syndrome is characterized by:

  • 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 glucose level
Coronary Heart Disease

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Causes
The exact cause of metabolic syndrome is not known. It believed to be due to a combination of factors, such as:

  • Genetic factors
  • Central obesity
  • Lack of physical activity
  • Poor diet
Risk Factors
Metabolic syndrome is more common in people who are Hispanic, Caucasian, or African American. Factors that increase your risk of metabolic syndrome include:

  • Obesity
  • Having disorders or conditions associated with metabolic disorder such as:
  • Genes—Having a family history of the disorders listed above
  • Physical inactivity
  • Poor diet
  • Unhealthy habits, such as smoking
  • Certain medications, such as atypical antipsychotics
Symptoms
Symptoms include:

  • Obesity
  • Dark, velvety skin discoloration
Diagnosis
You may be diagnosed with metabolic syndrome if you have at least three of the following:

  • 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)
*mg/dL = milligrams per deciliter blood, mmol/L = millimoles per liter blood

Treatment
The treatment of metabolic syndrome involves:

  • Treatment of underlying causes
  • Treatment of specific metabolic abnormality
Gastric bypass or other weight loss surgery may be helpful to treat metabolic syndrome. Talk to your doctor to learn if this is an option for you.

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
To reduce your chances of metabolic syndrome, take these steps:

  • 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

National Institute of Diabetes and Digestive and Kidney Diseases

CANADIAN RESOURCES:
Canadian Cardiovascular Society

Canadian Diabetes Association

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_UCM_002080_SubHomePage.jsp. Accessed June 4, 2014.

Metabolic syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 29, 2013. Accessed June 4, 2014.

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 June 4, 2014.

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 http://www.ebscohost.com/dynamed: 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: 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: 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.

Last Reviewed May 2014



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