Metabolic Syndrome

Topic Overview

What is metabolic syndrome?

Metabolic syndrome is a group of health problems that include too much fat around the waist, elevated blood pressure, high triglycerides, elevated blood sugar, and low HDL cholesterol.

Together, this group of health problems increases your risk of heart attack, stroke, and diabetes.

What causes metabolic syndrome?

Metabolic syndrome is caused by an unhealthy lifestyle that includes eating too many calories, being inactive, and gaining weight, particularly around your waist. This lifestyle can lead to insulin resistance, a condition in which the body is unable to respond normally to insulin. If you have insulin resistance, your body cannot use insulin properly, and your blood sugar will begin to rise. Over time, this can lead to type 2 diabetes.

Why is metabolic syndrome important?

This syndrome raises your risk for coronary artery disease (CAD), even beyond that caused by high LDL cholesterol alone.footnote 1 It also increases your risk for diabetes.

What increases your chance of developing metabolic syndrome?

The things that make you more likely to develop metabolic syndrome include:footnote 1

  • Insulin resistance. This means that your body cannot use insulin properly.
  • Abdominal obesity. This means having too much fat around your waist.
  • Age. Your chances of developing metabolic syndrome increase as you get older.
  • Lack of exercise. If you do not exercise, you are more likely to be obese and develop metabolic syndrome.
  • Hormone imbalance. A hormone disorder such as polycystic ovary syndrome (PCOS), a condition in which the female body produces too much of certain hormones, is associated with metabolic syndrome.
  • Family history of type 2 diabetes. Having parents or close relatives with diabetes is associated with metabolic syndrome.
  • A history of diabetes during pregnancy (gestational diabetes).
  • Race and ethnicity. African Americans, Hispanics, Native Americans, Asian Americans, and Pacific Islanders are at higher risk than whites for type 2 diabetes.

How is metabolic syndrome diagnosed?

Your doctor can diagnose metabolic syndrome with a physical exam, your medical history, and some simple blood tests.

You may be diagnosed with metabolic syndrome if you have three or more of the risk factors listed in the table below. Note: These criteria were developed by the National Heart, Lung, and Blood Institute. Other organizations may have different criteria for diagnosis.

Criteria for metabolic syndrome footnote 1

Risk factor

Defining level


Abdominal obesity (waist measurement)


Men: 40 in. (102 cm) or more

Women: 35 in. (88 cm) or more


Triglycerides


150 mg/dL or higher, or taking medicine for high triglycerides


High-density lipoprotein (HDL) cholesterol


Men: Less than 40 mg/dL

Women: Less than 50 mg/dL

Or taking medicine for low HDL cholesterol


Blood pressure


130/85 mm Hg or higher, or taking medicine for high blood pressure


Fasting blood sugar


100 mg/dL or higher, or taking medicine for high blood sugar

How is it treated?

The main goal of treatment is to reduce your risk of coronary artery disease (CAD) and diabetes. The first approaches in treating metabolic syndrome are:

  • Weight control. Being overweight is a major risk factor for CAD. Weight loss lowers LDL cholesterol and reduces all of the risk factors for metabolic syndrome.
  • Physical activity. Lack of exercise is a major risk factor for CAD. Regular exercise can help improve cholesterol levels. It can also lower blood pressure, reduce insulin resistance, lower blood sugar levels, and improve heart function.
  • Assessing risk category for CAD and diabetes. Then you and your doctor may discuss other treatments to lower LDL, high blood pressure, or high blood sugar.

References

Citations

  1. Grundy SM, et al. (2005). Diagnosis and management of the metabolic syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112(17): 2735-2752.

Other Works Consulted

  • Alberti K, et al. (2009). Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force of Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16): 1640-1645.
  • Brownlee M, et al. (2011). Complications of diabetes mellitus. In S Melmed et al., eds., Williams Textbook of Endocrinology, 12th ed., pp. 1462-1551. Philadelphia: Saunders.
  • Eckel RH (2012). The metabolic sydrome. In DL Longo et al., eds., Harrison's Principals of Internal Medicine, 18th ed., vol. 2, pp. 1992-1997. New York: McGraw-Hill.
  • Hawkins M, Rossetti L (2005). Insulin resistance and its role in the pathogenesis of type 2 diabetes. In Joslin's Diabetes Mellitus, 14th ed., pp. 425-448. Philadelphia: Lippincott Williams and Wilkins.
  • Masharani U, German MS (2011). Pancreatic hormones and diabetes mellitus. In DG Gardner, D Shoback, eds., Greenspan's Basic and Clinical Endocrinology, 9th ed., pp. 573-655. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Jennifer Hone, MD - Endocrinology, Diabetes and Metabolism

Current as ofMarch 15, 2018