Metabolic syndrome refers to the presence of a cluster of risk factors specific for cardiovascular disease. Metabolic syndrome greatly raises the risk of developing diabetes, heart disease, stroke, or all three.
According to the National Heart, Lung and Blood Institute (NHLBI), the cluster of metabolic factors involved includes:
The NHLBI and AHA recommend a diagnosis of metabolic syndrome when a person has 3 or more of these factors.
Most people who have metabolic syndrome have insulin resistance. The body makes insulin to move glucose (sugar) into cells for use as energy. Obesity, commonly found in people with metabolic syndrome, makes it more difficult for cells in the body to respond to insulin. If the body can’t make enough insulin to override the resistance, the blood sugar level increases, causing type 2 diabetes. Metabolic syndrome may be a start of the development of type 2 diabetes.
Experts don't fully understand what causes metabolic syndrome. Several factors are interconnected. Obesity plus a sedentary lifestyle contributes to risk factors for metabolic syndrome. These include high cholesterol, insulin resistance, and high blood pressure. These risk factors may lead to cardiovascular disease and type 2 diabetes.
Because metabolic syndrome and insulin resistance are closely tied, many healthcare providers believe that insulin resistance may be a cause of metabolic syndrome. But they have not found a direct link between the two conditions. Others believe that hormone changes caused by chronic stress lead to abdominal obesity, insulin resistance, and higher blood lipids (triglycerides and cholesterol).
Other factors that may contribute to metabolic syndrome include genetic changes in a person's ability to break down fats (lipids) in the blood, older age, and problems in how body fat is distributed.
Knowing your risk factors for any disease can help guide you to take the appropriate actions. This includes changing behaviors and being monitored by your healthcare provider for the disease.
Risk factors most closely tied to metabolic syndrome include:
Having high blood pressure, high triglycerides, and being overweight or obese may be signs of metabolic syndrome. People with insulin resistance may have acanthosis nigricans. This is darkened skin areas on the back of the neck, in the armpits, and under the breasts. In general, people do not have symptoms.
The symptoms of metabolic syndrome may look like other health conditions. See your healthcare provider for a diagnosis.
Expert organizations have developed criteria to diagnose metabolic syndrome. Criteria include:
Each organization has its own guidelines for using the above criteria to diagnose metabolic syndrome.
Your healthcare provider will figure out the best treatment for you based on:
Because metabolic syndrome increases the risk of developing more serious long-term (chronic) conditions, getting treatment is important. Without treatment, you may develop cardiovascular disease and type 2 diabetes. Other conditions that may develop as a result of metabolic syndrome include:
Here are the types of treatment that may be recommended for metabolic syndrome.
Treatment usually involves lifestyle changes. This means losing weight, working with a dietitian to change your diet, and getting more exercise. Losing weight increases HDL ("good") cholesterol and lowers LDL ("bad") cholesterol and triglycerides. Losing weight can also reduce the risk for type 2 diabetes.
Losing even a modest amount of weight can lower blood pressure and increase sensitivity to insulin. It can also reduce the amount of fat around your middle. Diet, behavioral counseling, and exercise lower risk factors more than diet by itself.
Other lifestyle changes include quitting smoking and cutting back on the amount of alcohol you drink.
Changes in diet are important in treating metabolic syndrome. According to the AHA, treating insulin resistance is the key to changing other risk factors. In general, the best way to treat insulin resistance is by losing weight and getting more physical activity. You can do this by doing the following:
Exercise helps people who are overweight or obese by helping to keep and add lean body mass, or muscle tissue, while losing fat. It also helps you lose weight faster than just following a healthy diet because muscle tissue burns calories faster.
People who have metabolic syndrome or are at risk for it may need to take medicine as treatment. This is especially true if diet and other lifestyle changes have not made a difference. Your doctor may prescribe medicine to help lower blood pressure, improve insulin metabolism, lower LDL cholesterol and raise HDL cholesterol, increase weight loss, or some combination of these.
Weight-loss surgery (bariatric surgery) is an effective treatment for morbid obesity in people who have not been able to lose weight through diet, exercise, or medicine. It may also help people who are less obese but who have significant complications from their obesity.
Metabolic syndrome greatly raises the risk of developing diabetes, heart disease, stroke, or all three.
The best way to prevent metabolic syndrome is to maintain a healthy weight, eat a healthy diet, and be physically active. Your diet should have little salt, sugars, solid fats, and refined grains.
Metabolic syndrome is a lifelong condition that will require changes in your lifestyle. If you already have heart disease or diabetes, follow your healthcare provider’s recommendations for managing these conditions.
Lifestyle changes involved in managing metabolic syndrome include:
Tips to help you get the most from a visit to your healthcare provider: