Metabolic syndrome is a term used to describe a cluster of
conditions that significantly increase the risk of developing type
2 diabetes and cardiovascular disease.
You may be 4 to 20 times more likely to have a heart attack if
you have conditions associated with metabolic syndrome than do
people without these conditions.
The conditions that make up metabolic syndrome can include
prediabetes or insulin resistance (impaired ability to use
insulin), obesity in the area around the waist (central obesity),
low levels of HDL ("good") cholesterol, high levels of
triglycerides (fats in the bloodstream) and high blood pressure.
Diagnosis involves the presence of three of these conditions.
Other conditions may also be present, such as type 2 diabetes,
hyperinsulinemia (excessive insulin in the blood),
hyperuricemia (excessive uric acid in the blood) and
microalbuminuria (small amounts of protein in the urine)
and. These disorders have additional risks. For example,
microalbuminuria indicates early-stage kidney dysfunction, and
hyperinsulinemia has been linked to conditions including gout,
kidney stones, blood clots and some types of cancer.
Obesity is often the tell-tale indicator of metabolic syndrome.
As a result, treatment programs often begin with programs designed
to help you lose weight, exercise regularly and modify your
diet.
There is a debate within the medical community about whether or
not metabolic syndrome should be classified as its own condition.
The American Diabetes Association (ADA) and the European
Association for the Study of Diabetes issued a joint statement in
2005 that challenged the definition and even existence of metabolic
syndrome. The organizations suggested that doctors should not treat
metabolic syndrome as a separate condition, but rather treat a
patient's various ailments by themselves. However, some other
organizations continue to find it useful to discuss metabolic
syndrome as a disorder in itself.
Many researchers believe that metabolic syndrome begins with
insulin resistance, an impairment in the body's ability to use this
glucose-regulating hormone. This leads to higher glucose levels in
the blood (hyperglycemia). These events can promote unhealthy
levels of blood fats, such as insufficient HDL "good" cholesterol
and excessive amounts of LDL "bad" cholesterol and triglycerides.
Excessive insulin may interfere with the ability to metabolize
salt, which can raise blood pressure.
Although obesity, lack of exercise and other environmental
factors (e.g., stress, smoking, poor diet) are believed to be
related to insulin resistance, the underlying cause or causes are
not completely understood.
The American Heart Association (AHA) estimates that as many as
one-fourth of adults in the United States have metabolic
syndrome.
Metabolic syndrome is more common among certain ethnic groups.
The AHA has reported that African American women are about 60
percent more likely than African American men to have the
condition. In addition, Mexican Americans (of whom an estimated 32
percent have metabolic syndrome) are more likely to develop insulin
resistance and unfavorable distribution of body fat.
Postmenopausal women tend to have a higher risk of developing
metabolic syndrome than premenopausal women.
The risk of insulin resistance increases if you are pregnant,
and is thought to increase with subsequent pregnancies.
The risk of developing metabolic syndrome increases with age.
The AHA has stated that less than 7 percent of people in their 20s
have the condition, compared to more than 40 percent of people in
their 60s.
You are more likely to develop metabolic syndrome if you have a
family history of type 2 diabetes or if you have previously had
gestational diabetes (diabetes that develops during
pregnancy).
Other conditions that can increase your risk of developing
metabolic syndrome include cardiovascular disease, high blood
pressure, stress, heredity or genetic predisposition, and
polycystic ovarian syndrome (PCOS), a disorder in which a woman's
ovaries produce excess male-type hormones.
If exercise and dietary changes alone are unsuccessful in
treating metabolic syndrome, your doctor may prescribe medications
such as weight-loss drugs, insulin sensitizers, blood pressure
drugs, cholesterol drugs or aspirin.
Patients who smoke are urged to quit because smoking promotes
insulin resistance, high blood pressure, heart disease, diabetes
and other diseases.
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