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Metabolic Syndrome

Metabolic syndrome is a set of abnormal biochemical processes gone awry which increases the risk of many widespread diseases, most prominently, cardiovascular disease and Type 2 Diabetes.  Like many diseases, metabolic syndrome is also known by other names such as syndrome x, insulin resistance syndrome and prediabetes. There are five physiological conditions that are used to identify Metabolic Syndrome but only three of them must be present at the same time for a confirmed diagnosis:

  • Abdominal obesity.
  • High blood pressure
  • Increased blood glucose due to insulin resistance
  • Elevated triglyceride levels
  • Low HDL levels (this is the good kind of fat that gets rid of bad fats)

Factors that favor metabolic syndrome development

The main factor is abdominal obesity as both a cause and symptom. When excessive adipose tissue is accumulated in the abdomen with a correspondingly low abdominal muscle bulk, a high waist to hip ratio develops. The following contribute to metabolic syndrome:

  • Sedentarism
  • Age
  • Race
  • Lypodystrophy
  • Increased  free fatty acids in the liver
  • Higher presence of fatty tissue in muscle cells
  • Insulin resistance sets in due to excess amounts of insulin in circulation (hyperinsulinemia)
  • Breakdown of glucose is impaired due to insulin resistance which increases the risk of diabetes type 2
  • Increase in the plasma levels of cholesterol and/or triglycerides.
  • Low levels of high-density lipoproteins (HDL, good cholesterol)
  • Atherosclerosis – fatty plaque deposits in the blood vessel walls. This reduces the size of the arterial lumen resulting in decreased blood flow.
  • Hypertension.
  • Hyperuricemia
  • Increased blood coagulation with arterial hyper-inflammation which further destroys the state of blood vessels

If not managed in time, metabolic syndrome can lead to chronic conditions such as:

  • Steatohepatitis (non-alcoholic) – Hepatic deposits of adipose tissue and liver inflammation. This condition can progress to become liver cirrhosis
  • Renal pathologies
  • Polycystic Ovarian Syndrome in women.
  • Sexual disorders in men
  • Low testosterone levels

In most cases the symptoms seen are those of the complications of metabolic syndrome.

How is metabolic syndrome diagnosed?

The main diagnostic factor is the size of the waist. The risk differs in people of different races but a woman with central obesity and a waist above 28 inches is at risk. For men the risk begins from a waist measuring 31 inches together with large abdominal fat deposits. Other considerations include:

  • History of blood glucose (fasting) level above 100mg/dl
  • Blood pressure consistently higher than 130mmHg/85mmHg
  • Elevated triglyceride levels during fasting (above 150mg/dl)
  • Levels of high density lipoprotein (HDL) below 50mg/dl in women


Treatment of metabolic syndrome

There are two major ways of treating this condition:

  1. Lifestyle changes

It is paramount to reduce the waistline by eliminating abdominal fat. Some of the ways to do this include:

  • Exercise and an active lifestyle. This will take you a long way in the road to recover.
  • A healthy diet. – This, only when combined with an active lifestyle, is the most potent tool in your management/prevention arsenal.
  • Reduction of alcohol consumption
  • Cessation of smoking.
  1. Medications

Appropriate drugs are given to treat problems accompanying metabolic syndrome. Common ones used include:

  • Anti-insulin resistance medications such as metformin or drugs in the group of thiazolidinediones
  • Management of cardiovascular disorders. This includes medications for high blood pressure and others that lower the levels of triglycerides in the blood.

Treatment regime is determined by the presence of any other complication which must be managed independently in an effort to reverse metabolic syndrome.

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