Metabolic syndrome also known as “syndrome X” or “insulin resistance syndrome”, is not a disease, but merely refers to a cluster of metabolic disorders such as hypercholesterolemia, hypertension and insulin resistance, when happen together; raise the risk for cardiovascular disease and type two diabetes. This concept is well accepted even though the criteria of diagnosis for metabolic syndrome are slightly different between different authorities such as the International Diabetes Federation (IDF), the World Health Organization (WHO), the European Group for the Study of Insulin Resistance (EGIR) and the US National Cholesterol Education Program Adult Treatment Panel III (NCEP).
Metabolic syndrome has high prevalence in the United States. There is one patient with metabolic syndrome in five Americans, and it gets more common with age.
What Causes Metabolic Syndrome
Central obesity (extra fat tissue around the waist) appears to be the main factor in causing metabolic syndrome. However, it is possible for a person with normal body weight to have insulin resistance and get this syndrome.
Insulin resistance is another factor. It occurs when the fat and muscle cells are resisting hormone insulin, causing inadequate uptake of glucose. As a result, persistent hyperglycemia or diabetes occurs.
Stress indirectly leads to the development of metabolic syndrome by causing hormonal disorders. Chronic stress will lead to persistent hypercortisolemia, which will ultimately lead to hypertension, increased visceral fat deposition, dyslipidemia and osteoporosis.
Metabolic syndrome occurs more common in elderly people (older than 50 year-old), people with family history of the risk factors, and people with low physical activity level.
Other possible underlying causes are such as high caloric intake, smoking habit, polycystic ovarian syndrome in reproductive age women, cholelith (gallstone) and sleep apnea. Excessive blood clotting and low grades of inflammation throughout the body are two factors that some researchers unsure whether they are the cause, or they make the condition worse.
Symptoms of Metabolic Syndrome
A patient with at least three of the following is diagnosed as having metabolic syndrome. Most of the symptoms are determined from laboratory testing.
Central obesity
The waist circumference is greater than 40 inches for men and greater than 35 inches for women.
Hypertension
The blood pressure is 130/85 mmHg or above. The patient may have dull headaches, vertigo or abnormal epistaxis.
Hyperglycemia
The fasting blood glucose concentration is 110 mg/dL or above. The patient may have nocturnal polyuria, fatigue, and blurred vision.
Hyperlipidemia
The serum triglyceride concentration is 150 mg/dL or above.
Sub-normal high-density lipoprotein (HDL) cholesterol concentration (“good” cholesterol)
The concentration is 40 mg/dL or below in men and 50 mg/dL or below in women.
Treatments for Metabolic Syndrome
The main goal of treatment is to reduce the risk of developing cardiovascular disease. The first line treatment is change to a healthy lifestyle. If it does not effectively control the metabolic syndrome, medical treatments would be the second option.
i) Healthy lifestyle:
Lose weight
It must be done gradually until a body mass index (BMI) below 25 is achieved. BMI is an estimation of total body fat.
Regular exercise
Choose activities such as swimming, walking, jogging and cycling for 4-6 times a week, and for about 30-60 minutes each time.
Healthy diet
Daily diet with low fat, low calorie and high dietary fiber is good. They are such as fruits, vegetables, and whole grain bread. Diet with high sodium, added sugar, trans fat and saturated fat should be avoided. Alcohol intake should be reduced or strictly prohibited.
Stop smoking
Smoking habit must be terminated.
Reduce stress
Exercise can reduce stress level. One can join some social classes or activities such as singing or dancing to de-stress.
ii) Medical treatments:
Specific medicine is prescribed for specific disorder.
Hypertension
Diuretics and ACE inhibitors are commonly used in controlling blood pressure.
Hypertriglyceridemia
Statins, fibrates and nicotinic acid are used to reduce serum triglyceride concentration.
Hyperglycemia
Metformin or insulin injection are used for regulating blood glucose concentration.
Blood clots
Aspirin is used to reduce the risk of getting blood clots.
How to Prevent Metabolic Syndrome
A healthy lifestyle is the main option in preventing metabolic syndrome. A normal BMI or body weight should be well-controlled by getting them measured at regular basis. A daily healthy diet consists of high quality protein, low carbohydrate, low fat, and high dietary fiber is the best. Added sugar, sodium, and saturated fat must be avoided. Exercise at regular basis can help to control body weight and stress level. Smoking habit must be terminated as soon as possible.
A regular body check including blood panel is necessary to keep one updated on the cholesterol concentration, blood pressure, and blood glucose concentration.
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