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Metabolic Syndrome

(Syndrome X; Insulin Resistance Syndrome; Dysmetabolic Syndrome)

 

Definition

Metabolic syndrome is a combination of risk factors that increase your risk of heart disease, diabetes, and stroke. It is diagnosed when at least 3 of the following are present: high blood pressure, high triglyceride levels, large waistline, low HDL (good) cholesterol, and high fasting blood sugar.

Coronary Artery Disease

Stereostatic Biopsy

Copyright © Nucleus Medical Media, Inc.

 

Causes    TOP

The exact cause of metabolic syndrome is not known. It believed to be due to a combination of factors, such as:

  • Genetic factors
  • Lack of physical activity
  • Poor diet
 

Risk Factors    TOP

Metabolic syndrome is more common in people who are Hispanic, Caucasian, or African American. Factors that may increase your chance of metabolic syndrome include:

  • Having disorders or conditions associated with metabolic disorder such as:
  • History of gestational diabetes
  • Family history of the disorders listed above
  • Physical inactivity
  • Poor diet
  • Unhealthy habits, such as smoking
  • Certain medications, such as atypical antipsychotics
 

Symptoms    TOP

Symptoms may include:

  • Frequent urination, and excessive thirst and hunger due to high blood sugars
  • Dark, velvety skin discoloration seen with obesity
 

Diagnosis    TOP

Metabolic syndrome is diagnosed when at least 3 of the following are present: high blood pressure, high triglyceride levels, large waistline, low HDL (good) cholesterol, and high fasting blood sugar. You may be diagnosed with metabolic syndrome if you have:

  • Waist measurement—greater than 40 inches in Caucasian men (35 inches in Asian men) or 35 inches in Caucasian women (30 inches in Asian women) and/or
  • At least 2 of the following:
    • Fasting glucose level—greater than or equal to 100 mg/dL* (5.55 mmol/L)
    • Triglyceride level—greater than or equal to 150 mg/dL (1.7 mmol/L)
    • HDL cholesterol—less than 40 mg/dL (1.0 mmol/L) in men and less than 50 mg/dL (1.3 mmol/L) in women
    • Blood pressure—greater than or equal to 130/85 millimeters of mercury (mm Hg)

*mg/dL = milligrams per deciliter of blood, mmol/L = millimoles per liter of blood

 

Treatment    TOP

The treatment of metabolic syndrome involves:

  • Treatment of underlying causes, usually by diet and exercise
  • Treatment of specific metabolic abnormality

Gastric bypass or other weight loss surgery may be helpful to treat metabolic syndrome if obesity is severe. Talk to your doctor to learn if this is an option for you.

Treatment of Underlying Causes

  • Reducing excess weight by at least 10% in the next 6-12 months
  • Increasing physical activity to 30-60 minutes of moderate aerobic exercise four or more days per week as approved by your doctor
  • Lowering blood pressure to below 120/80 mmHg with diet, exercise, and possibly medication
  • Improving triglyceride and HDL cholesterol levels through diet, exercise, and possibly medication

Treatment of Specific Metabolic Abnormalities

  • High blood pressure—treated with anti-hypertensive medication and lifestyle changes
  • Insulin resistance—treated with diabetes medications and lifestyle changes
  • High cholesterol—treated with cholesterol-lowering medications called statins and lifestyle changes
  • Clotting tendency—treated with low-dose aspirin, especially in those with moderate to high cardiovascular risk
 

Prevention    TOP

To help reduce your chances of metabolic syndrome:

  • If you smoke, talk to your doctor about how to successfully quit.
  • Achieve and maintain a healthy weight by eating a balanced diet.
  • Talk to your doctor how to increase your intake of specific minerals, such as magnesium.
  • Work up to 30 minutes of moderate aerobic exercise most days of the week.
  • Drink alcohol in moderation. This means no more than 2 drinks daily for men, 1 drink daily for women.
RESOURCES:

American Heart Association
http://www.heart.org

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Cardiovascular Society
http://www.ccs.ca

Canadian Diabetes Association
http://www.diabetes.ca

REFERENCES:

Batsis JA, Romero-Corral A, Collazo-Clavell ML, et al. Effect of bariatric surgery on the metabolic syndrome: a population-based, long-term controlled study. Mayo Clin Proc. 2008;83(8):897-907.

Deen D. Metabolic syndrome: time for action. Am Fam Physician. 2004;69(12):2875-2882.

Explore metabolic syndrome. National Heart, Lung, and Blood Institute website. Available at:
...(Click grey area to select URL)
Updated August 22, 2012. Accessed February 12, 2018.

Gami AS, Witt BJ, Erwin PJ, et al. Metabolic syndrome and risk of incident cardiovascular events and death. J Am Coll Cardiol. 2007;49(4):403-414.

Grundy SM, Brewer HB, Cleeman JI, et al. Definition of metabolic syndrome: report of the NHLBI/AHA conference on scientific issues related to definition. Circulation. 2004;109(3):433-438.

Grundy SM, Cleeman JI, Daniels SR. et al. AHA/NHLBI Diagnosis and management of the metabolic syndrome: an AHA/NHLBI Scientific Statement. Circulation. 2005;112(17):2735-2752.

Metabolic syndrome. American Heart Association website. Available at:
...(Click grey area to select URL)
Accessed February 12, 2018.

Metabolic syndrome in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults . Updated January 11, 2018. Accessed February 12, 2018.

Wright JT, Harris-Haywood S, Pressel S, et al. Clinical outcomes by race in hypertensive patients with and without the metabolic syndrome (ALLHAT). Arch Int Med. 2008;168(2):207-217.

1/13/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults : Salas-Salvadó J, Fernández-Ballart J, Ros E, et al. Effect of a Mediterranean diet supplemented with nuts on metabolic syndrome status: one-year results of the PREDIMED randomized trial. Arch Intern Med. 2008;168(22):2449-2458.

2/17/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults : Davidson LE, Hudson R, Kilpatrick K, et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med. 2009;169(2):122-131.

5/11/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults : Nettleton JA, Lutsey PL, Wang Y, et al. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. 2009;32(4):688-694.

1/22/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults : Xu Y, Shen S, Sun L, et al. Metabolic syndrome risk after gestational diabetes: Asystematic review and meta-analysis. PLoS One. 2014;9(1):e87863.

7/15/2015 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113812/Metabolic-syndrome-in-adults : Dibaba DT, Xun P, Fly AD, Yokota K, He K. Dietary magnesium intake and risk of metabolic syndrome: A meta-analysis. Diabet Med. 2014;31(11):1301-1309.



Last reviewed March 2018 by EBSCO Medical Review Board David A. Ostrovsky, MD
Last Updated: 8/16/2016

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