Metabolic Syndrome

What is metabolic syndrome?

The term metabolic syndrome describes a cluster of risk factors that increase the chances of developing heart disease, stroke, and/or diabetes (high blood glucose, also called high blood sugar). The exact cause of metabolic syndrome is not known but genetic factors, too much body fat (especially in the waist area, the most dangerous type of fat), and lack of exercise add to the development of the condition. One in five Americans has metabolic syndrome.

You are diagnosed with metabolic syndrome if you have three or more risk factors:

• Large amount of abdominal fat: Waist measurement of 40 inches (102 cm) or more in men; 35 inches (88 cm) or more in women*
• Low HDL (“good”) cholesterol: Less than 40 mg/dl in men; less than 50 mg/dl in women or use of medications for low HDL (fibrates or niacin)
• High triglycerides (levels of fat in the blood): 150 mg/dl or higher or use of medications for high triglycerides (fibrates or niacin) 
• High blood pressure: 180/85 mmHg or higher, or use of blood pressure medications 
• High blood glucose (sugar): Fasting glucose of 100 mg/dl or higher or use of diabetes medications

*90 cm in men and 80 cm in women in Asia.

Having three or more risk factors is a sign that the body is resistant to insulin, an important hormone produced by the pancreas. This resistance to insulin means that more insulin than normal is needed to keep normal glucose levels.

Who is at risk for metabolic syndrome?

The syndrome runs in families and is more common among African Americans, Hispanics, Asians, and Native Americans. For all people, the chances of developing the syndrome rises as people get older. You might be at risk for the syndrome if you don’t get much exercise and have:

• Gained weight, especially around the waist
• parent or sibling with type 2 diabetes 
• High levels of fat or glucose in your blood
• High blood pressure

Most people who have metabolic syndrome feel healthy and may not have any signs or symptoms, especially if they are not obese. However, they are at risk of developing life-threatening diseases like diabetes and/or heart disease in the future.

How is metabolic syndrome treated?

Increasing physical activity and losing weight are the best ways to prevent metabolic syndrome or to begin to manage your condition. The standard exercise recommendation is a minimum of 30 minutes of moderate-intensity (such as brisk walking) physical activity, on 5 or more days of the week. 

Medications can also be used to treat risk factors such as high blood pressure or high blood glucose (e.g., metformin) 

If you think you have risk factors for metabolic syndrome, talk with your doctor. Your doctor can run blood tests and measure your waist circumference to see if you have metabolic syndrome, and determine the best treatment option for you. Finding out if you have metabolic syndrome can give you a peek into your future health and see if you are headed down the path to heart disease. It will also give you time to make important lifestyle changes before serious complications develop.

Questions to ask your doctor

• What can I do to overcome metabolic syndrome?
• What are my options for treatment?
• What are the advantages and disadvantages of each treatment option?
• What’s the best way to lose weight?
• How much weight do I need to lose? 
• What kind of exercise is best for me?
• Should I see an endocrinologist for my care?