Metabolic Syndrome

Metabolic syndrome is one of the most common health conditions in the world, although complete understanding and awareness of it are quite limited. Metabolic syndrome does not include only one condition; in fact, it is defined as a cluster of health risks, which together increase the patient’s risk of having a stroke, diabetes, cancer or heart disease. These conditions include: excess fat around the waist, high cholesterol and triglyceride levels, high blood sugar, high blood pressure. All of these conditions can be present on their own, with no connection to metabolic syndrome. Metabolic syndrome occurs when the patient suffers from two or more of them at the same time.

 

Overview & Facts About Metabolic Syndrome

One of the most interesting facts about metabolic syndrome is that it was introduced in medical textbooks very recently, in 1998 and its causes are still being researched. Other names for metabolic syndrome include “syndrome X”, “insulin resistance syndrome,” and “American syndrome”. However, this condition is very widespread, some experts estimating that it is as common as acne and the common cold. In the United States, more than 45 million people have it. One in six people is expected to develop metabolic syndrome at one point in their lives, especially after the age of 65. In the past years, the incidence of metabolic syndrome has increased, one possible cause being the rise in obesity rates. At present, it is estimated that almost 35% of Americans suffer from metabolic syndrome. Nearly half the instances of metabolic syndrome occur in people over the age of 60.

 

Signs and Symptoms of Metabolic Syndrome

Metabolic syndrome can go undiagnosed for years because sometimes there are no symptoms of metabolic syndrome or they are very subtle and the patient does not notice them. However, some seemingly innocent signs can announce the presence of this cluster of conditions. Metabolic syndrome signs include:

  • Excess fat concentrated around the belly. Patients who are at risk of developing metabolic syndrome have an apple body shape and a large waist circumference. This is also called central obesity and it can be determined at home by following these simple steps:
  • Measuring the waist to hip ratio – measure your waist at its smallest point (around the navel) and your hips at their widest point. Then, divide the waist circumference by the hip circumference. If the result is higher than 0.95 inches in women or above 0.85 in men, then there is a higher risk of heart disease and stroke.
  • Measuring waist circumference – a wide waist is a clear sign of metabolic disease. If the waist measures more than 35 inches in women or more than 40 inches in men, then we are talking about a high risk of metabolic syndrome.
  • High blood pressure
  • High triglyceride levels
  • High cholesterol
  • High blood sugar – higher than normal blood sugar levels may cause diabetes symptoms such as the frequent need to urinate, extreme thirst and fatigue.

 

Apart from a wide waist circumference and high blood sugar, the rest of metabolic syndrome symptoms are not noticeable. The patient doesn’t feel that they have high cholesterol or high blood pressure unless they have a doctor measure these levels, which is why it is important not to skip routine medical examinations.

 

Causes of Metabolic Syndrome

The causes of metabolic syndrome are not yet fully understood, but there is a clear connection between the prevalence of metabolic syndrome and the following conditions:

  • Obesity – weighing more than normal leads to central obesity and thus increase the risk of metabolic syndrome.
  • Inactivity – living a sedentary lifestyle and not working out for at least 30 minutes every day causes obesity
  • Insulin resistance. When the body has insulin resistance, glucose cannot enter the blood stream. Therefore, the body produces more insulin and glucose levels rise.
  • An unhealthy diet rich in saturated fats and sugar
  • Stress – studies have shown that high stress levels disrupt hormonal balance, raise insulin and glucose levels, which in turn increase the risk of metabolic syndrome.

 

Metabolic Syndrome Diagnosis

Because the symptoms of metabolic syndrome are not always obvious and people who are not medical professionals might not be aware of the existence of this condition, accurate metabolic syndrome diagnosis can only be given by a doctor, after a series of investigations. These include:

  • A thorough analysis of the family history
  • Blood tests to determine cholesterol, blood sugar and triglyceride levels
  • Checking the heart pressure
  • Measuring the waist

If the patient has three of the five risk factors, then they are diagnosed with metabolic syndrome.

 

Metabolic Syndrome Risk Factors

Metabolic syndrome is a preventable condition and people can reduce the chances of getting it by checking these risk factors of metabolic syndrome:

  • Being over the age of 65 – the chance of developing metabolic syndrome rises as we get older
  • Statistically, Mexican American people are at a higher risk for metabolic syndrome
  • Being overweight, especially when most of the fat is concentrated around the belly button, increases the risk of metabolic syndrome.
  • Diabetes
  • Smoking
  • Previous history of cardiovascular disease, fatty liver disease or polycystic ovaries.
  • Family history of metabolic syndrome or heart disease
  • Mental illness. Although mental illnesses do not cause metabolic syndrome directly, they may lead to a lifestyle that triggers it. For example, people who suffer from bipolar disorder, schizophrenia, depression or neurological disorders have a disorganized and unhealthy lifestyle with irregular sleeping patterns, high stress levels, unhealthy diets and inactivity. It is very important for these patients to have their health monitored by friends, family members or healthcare professionals to reduce the risk of developing one of the conditions of metabolic syndrome.

 

Treatment and Care for Metabolic Syndrome

Because metabolic syndrome is not one condition, but a cluster of serious conditions, treatment is very complex and involves tackling each of them. First of all, metabolic syndrome treatment starts by making lifestyle changes to reduce the risk factors that may cause it or worsen it. This is the first course of action that doctors recommend. After diagnosis, the healthcare provider will identify the lifestyle habits that caused metabolic syndrome and develop a six months plan, suggesting gradual changes. These lifestyle changes play an essential role in the management and care for metabolic syndrome and, in some cases, they are enough to slow down the disease, making it easier to manage. From case to case, suggestions include:

  • Physical exercise. Patients who are overweight will have to develop a gradual fitness plan so that they become more active and give up the sedentary lifestyle.
  • Healthier diet. If the patient has an unhealthy, unbalanced diet consisting of fast food, excess sugar and excess fats, they will be asked to cut down on these foods and replace them with fruits, vegetables and non-saturated fats.
  • Avoiding stress. Persistent stress may reduce the effectiveness of metabolic syndrome treatment and if it is a major factor in the patient’s life, their healthcare provider will suggest them to reduce exposure to risk factors, engage in social activities and get more rest.

More often than not, if the patient respects the doctor’s suggestions, improvements will be noticeable during the follow-up examination after six months. However, if the degree of severity of the condition is the same, then further medical treatment will be required, including:

  • Cardiovascular exercise
  • Medicine that treats each condition separately: drugs for hypertension, cholesterol lowering drugs and drugs for weight loss if the patient cannot lose weight though diet changes alone.

In 2011, there has been an attempt to introduce one drug for metabolic syndrome, called Juvisync. It contained simvastatin and sitagliptin and was supposed to lower LDL levels and increase insulin levels. However, two years later it was discontinued for business reasons.

Although smoking itself does not cause metabolic disease, it increases the risk of high cholesterol and high blood pressure, so patients are advised to quit smoking as soon as possible.

 

Complications of Metabolic Syndrome

In general, metabolic syndrome has a good outlook, especially the patient respects the recommendations of the healthcare provider and try to lead a healthier lifestyle, with a balanced diet and physical exercise. Symptoms can be controlled and patients can continue to lead a normal life. However, there will always be a higher risk of cardiovascular diseases, stroke and other metabolic syndrome complications:

  • Failure to lose weight after metabolic syndrome diagnosis will lead to insulin resistance and higher glucose levels. This increases the risk of diabetes, which is why patients should look out for diabetes signs and symptoms and talk to their doctor about this prospect.
  • Buildup of plaque on the arteries as a result of high blood pressure and high cholesterol. When this happens, the arteries narrow and the patient might have a heart attack or a stroke.
  • Blood clots, which can cause a heart attack

 

Metabolic Syndrome Prevention

Metabolic syndrome prevention is very effective. According to a 2005 study, patients who already showed some of the main triggers of metabolic syndrome, but changed their lifestyle, showed a 40% improvement in their condition. Not only do these prevention methods help avoid metabolic syndrome, but also reduce the risk for other disorders and complications:

  • Maintaining a healthy body weight by exercising. The American Heart Association recommends between 30 and 60 minutes of physical exercises every day to prevent metabolic syndrome. Patients who have physical limitations that do not allow them to exercise can talk to a specialist to develop a gentler program adapted to their particular needs. It is very important to point out that even a little weight loss matters and patients should not be expected to achieve dramatic results immediately. In fact, losing as little as 8 pounds could lead to better test results.
  • A healthy diet. Fast food, trans fats, excess sugar and salt and foods high in cholesterol increase the risk of metabolic syndrome and they should be replaced with healthier alternatives: white meat, fruits and vegetables, healthy, non-saturated fats, low fat dairy products and whole grains. According to the latest research, diets based on fibers and plants, such as the Mediterranean one, can reduce the risk of metabolic syndrome because they lower cholesterol.
  • Avoid smoking, because it increases the risk of heart disease
  • Reducing alcohol intake
  • Having routine medical checkups. Because the symptoms of metabolic syndrome are not always obvious, patients can suffer from it without knowing. Although excess weight is described as the main symptom, there are numerous cases of people who have a normal weight, but present the rest of conditions which are not that easy to detect. Similarly, they may have a family history of metabolic syndrome and are at risk themselves. To avoid the risk of stroke and heart attack, everyone should undergo annual routine checkups and blood tests to find out if they are affected.

 

Living with Metabolic Syndrome

Metabolic syndrome is a serious condition, but the outlook is positive and it can be reversed if the patient changes his lifestyle to control risk factors. People who have been diagnosed with metabolic syndrome can lead normal lives, but they have to pay more attention to physical exercises, healthy nutrition and avoid bad habits such as smoking and excess alcohol. If their healthcare provider recommended them drugs to maintain blood pressure, blood sugar and cholesterol under control, they should continue taking these drugs for the prescribed period. Last, but not least, they should not skip their routine checkups and schedule regular medical visits to make sure their condition is kept under control.

AAOM Editor

Academic Association of Medicine is the go to resource for all health related issues. We are an independent body that seeks to offer general information on various health topics and unbiased reviews on health products.

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