Metabolic syndrome affects 47 million Americans as of 2010, according to the National Institutes of Health. The syndrome, which involves symptoms related to weight, blood pressure, cholesterol levels and blood sugar, places them at increased risk of stroke, Type 2 diabetes and heart disease.
Definition
Metabolic syndrome is also referred to as insulin resistance syndrome or syndrome X. According to the National Cholesterol Education Program, people have metabolic syndrome if they have at least three of the following: A blood glucose level of 100 mg/dL or higher eight hours after their last meal, a blood pressure of at least 130/85, high-density lipoproteins lower than 50 mg/dL if a woman or lower than 40 mg/dL if a man, triglycerides higher than 150 mg/dL, and a waist size of 35 inches or more if a woman or 40 inches or more if a man.
Risk Factors
The risk factors for metabolic syndrome are similar to the risk factors for Type 2 diabetes and cardiovascular disease. Although the pancreas may secrete enough insulin to keep glucose levels within a normal range, the organs of people with type 2 diabetes are resistant to insulin, which gives them high blood glucose levels. High blood pressure, being overweight or obese, and abnormal cholesterol levels are risk factors as well.
Cholesterol Levels
The recommended high-density lipoprotein cholesterol level is 60 mg/dL or higher. High-density lipoprotein, or HDL, has the nickname of "good cholesterol." This cholesterol, made in the liver and the intestines, takes cholesterol from the cells of the body to the liver, after which the cholesterol can be eliminated from the body. Triglyceride cholesterol levels, meanwhile, should be less than 150 mg/dL. This type of cholesterol is found in lipoproteins called chylomicrons and in very low-density lipoproteins.
Metabolic Syndrome and Cholesterol
As The Merck Manual for Healthcare Professionals explains, people with too much abdominal fat have too many free fatty acids accumulating in the portal vein that drains blood into the liver. This causes fats to accumulate in the liver. Too much fat also collects in the muscle cells, and the combined effect leads to insulin resistance. The pancreas releases more insulin at first, but eventually the fatty acids interfere, high glucose levels develop, and the triglycerides accumulate in the heart, skeletal muscles and liver.
Treatment
Because obesity is the main cause of metabolic syndrome, the primary treatment is to lose weight. Patients typically are advised to get 60 to 90 minutes of daily physical activity, lower their blood pressure and eat healthful foods. Diet and lifestyle goals are aimed at lowering LDL levels less than 100 mg/dL and triglycerides to less than 150 mg/dL. Saturated fats should represent less than 7 percent of daily calories, and patients should eat few or no trans-fats and less than 200 mg of cholesterol each day.
References
- Handbook of Pathophysiology; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Metabolic Syndrome
- National Institutes of Health: ATP III At-A-Glance: Quick Desk Reference
- National Institutes of Health: Metabolic Syndrome
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