The Metabolic Syndrome (also known as Syndrome X, or insulin resistance syndrome) consists of a constellation of metabolic abnormalities leading to increased risk of Diabetes and Heart disease. The major features of Metabolic Syndrome include central obesity, high triglycerides, low HDL Cholesterol, hyperglycemia (high blood glucose) and hypertension.
The risk factors for Metabolic Syndrome are:
- Overweight/ Obesity: There is a strong relationship between waist circumference and prevalence of the syndrome.
- Sedentary lifestyle: major factors for development of Metabolic Syndrome are associated with sedentary lifestyle including high triglycerides, high BP and increased glucose.
- Aging: A greater percentage of women over the age 50 have the syndrome than men.
- Diabetes mellitus : Presence of metabolic syndrome in diabetic population is associated with higher risk of coronary heart disease
- Coronary heart disease: Approximately 50% patients of coronary heart disease are seen to have metabolic syndrome with prevalence of 37% in patients with young age heart disease ≤ age 45
- Criteria for diagnosis of Metabolic Syndrome are three or more of the following:
- Central obesity: Waist circumference ≥ 90 cm for men and 80cm for women
- High triglycerides ≥ 150mg/dL or on medication
- Low HDL cholesterol <40mg/dL for men or 50mg/dL for women
- Hypertension: Blood pressure ≥ 130 mm systolic or ≥ 85mm diastolic or on medication
- Fasting blood glucose ≥ 100 mg/dL or on medication or previously diagnosed with type 2 Diabetes
Associated conditions with Metabolic Syndrome
- Fatty liver disease
- High uric acid levels
- PCOS (polycystic ovarian syndrome)
- Obstructive Sleep Apnea
Treatment:
- Lifestyle : Obesity is the driving force behind Metabolic syndrome. Weight reduction is the primary approach to this disorder. With weight reduction, improvement in insulin sensitivity is often accompanied by favorable modification in many components of the metabolic syndrome.
- Recommendations for weight loss include a combination of calorie restriction, increased physical activity and behavior modification.
- Caloric reduction is the most important component for weight reduction and physical activity for weight loss maintenance.
- Bariatric surgery is an option for patients with Metabolic syndrome who have a BMI > 40kg/m², or 35kg/m² with comorbidities (simultaneous presence of two chronic diseases).
- Reduction of LDL cholesterol and triglycerides.
- HDL cholesterol correction
- BP and blood sugar control through lifestyle modification and medications
