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Metabolic Syndrome

(Syndrome X; Insulin Resistance Syndrome; Dysmetabolic Syndrome)

Definition

Metabolic syndrome is a combination of conditions associated with obesity that may include high blood pressure, elevated blood lipids, and high fasting blood sugar.
Metabolic syndrome puts a person at risk for:
Metabolic syndrome may be characterized by:
Coronary Artery Disease
Stereostatic Biopsy
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Causes

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

Risk Factors

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

Symptoms

Symptoms may include:

Diagnosis

You may be diagnosed with metabolic syndrome if you have:
*mg/dL = milligrams per deciliter blood, mmol/L = millimoles per liter blood

Treatment

The treatment of metabolic syndrome involves:
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 130/85 mmHg with diet, exercise, and possibly medication
  • Improving triglyceride and HDL cholesterol levels through diet, exercise, and possibly medication

Treatment of Specific Metabolic Abnormality

  • 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

To reduce your chances of metabolic syndrome, take these steps:

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, 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;69:2875-2882.

Explore metabolic syndrome. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/ms. Updated November 3, 2011. Accessed June 4, 2014.

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

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

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

Metabolic syndrome. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MetabolicSyndrome/Metabolic-Syndrome%5FUCM%5F002080%5FSubHomePage.jsp. Accessed June 4, 2014.

Metabolic syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 29, 2013. Accessed June 4, 2014.

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

1/13/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Salas-Salvadó J, Fernández-Ballart J, 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;168:2449-2458.

2/17/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Davidson LE, Hudson R, et al. Effects of exercise modality on insulin resistance and functional limitation in older adults: a randomized controlled trial. Arch Intern Med. 2009;169:122-131.

5/11/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Nettleton JA, Lutsey PL, 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;32:688-694.

1/22/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Xu Y, Shen S, et al. Metabolic syndrome risk after gestational diabetes: Asystematic review and meta-analysis. PLoS One. 2014;9(1):e87863.

7/15/2015 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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.

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