Metabolic syndrome refers to a group of disorders that increase the risk for developing cardiovascular disease and type 2 diabetes. The International Diabetes Federation, or IDF, defines metabolic syndrome in people with central obesity and any two of the following disorders; triglycerides greater than 150 mg/dL; high density lipoproteins, or HDL cholesterol, lower than 40 mg/dL; systolic blood pressure above 100 mmHg or diastolic above 85 mmHg; fasting blood glucose levels greater than 100 mg/dL. The more metabolic disorders present in an individual, the higher the risk of cardiovascular disease.
Incidence and Complications
The IDF estimates that between 20 and 25 percent of adults have metabolic syndrome worldwide. An article on MedicineNet reports that this syndrome is present in 5 percent of people with normal body weight, in 22 percent of overweight people and in 60 percent of those who are obese. People with metabolic syndrome, the IDF notes, are two times more likely to have a heart attack or stroke, and are three times more likely to die from these events than others without the syndrome. The article on MedicineNet reports that people with metabolic syndrome are between 9 and 30 times more likely to develop type 2 diabetes.
Causes
Several factors play a role in the cause of metabolic syndrome. Some, like insulin resistance, obesity, and physical inactivity can be controlled. Others such as aging, genetic disposition and increased inflammation cannot.
Hypertension
A review in the April 2008 issue of the "Nutrition Journal" purports that one-third of patients with hypertension also have metabolic syndrome. Also, greater than half of people with metabolic syndrome also suffer from hypertension. Blood pressure levels highly correlate with the degree of obesity and insulin resistance. Hypertension is probably caused by many factors in people with metabolic syndrome. There is evidence to suggest that increase in chemicals that cause inflammation, blood vessel cell abnormalities, oxidative stress, obstructive sleep apnea and abnormal regulation of the renin-angiotensin system all play a role in increasing hypertension in subjects with metabolic syndrome.
Treatment
The IDF recommends that people with metabolic syndrome change their diet and restrict caloric intake so that they may achieve between a 5 and 10 percent weight loss in the first year, and increase physical activity. If lifestyle changes are not enough to reduce triglycerides, cholesterol and blood pressure, drug treatment is recommended. Drugs that act on more than one abnormality are considered a better option. An example is ACE inhibitors, which reduce blood pressure and decrease insulin resistance. A study in the "American Journal of Therapeutics" notes that ACE inhibitors also decrease the risk of developing type 2 diabetes. The National Lung, Heart and Blood Institute, or NLHBI states that the main goal of treatment for people with metabolic syndrome is to reduce cardiovascular risk by decreasing hypertension and lowering cholesterol.
Prevention
The NLHBI states that the best way to avoid developing metabolic syndrome is to maintain a normal level of abdominal fat and body weight. In women, waist circumference measurements should be less than 35 inches and in men less than 40 inches. The NHLBI also notes that a body mass index of less than 25 is the goal for preventing metabolic syndrome.
References
- International Diabetes Federation: The Metabolic Syndrome
- MedicineNet: Metabolic Syndrome
- "Nutrition Journal"; The Underlying Mechanisms for Development of Hypertension in the Metabolic Syndrome; Yana Hidekatsu et al.; April 2008
- "American Journal of Therapeutics"; Metabolic Syndrome: Treatment of Hypertensive Patients; Z.H. Israili et al.; July-August 2007
- The National Lung, Heart and Blood Institute: Metabolic Syndrome
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