Metabolic syndrome refers to a cluster of risk factors like hypertension (high blood pressure), larger waist circumference, high cholesterol and impaired fasting glucose which may identify individuals at greater risk of diabetes and heart disease. Although the metabolic syndrome concept itself has been around for more than 80 years, there has been controversy and debate over what it actually is and what it means in practice. There have been too many different definitions of metabolic syndrome, so people are now confused as to whether they have it or not. Moreover, there seems to be no evidence that metabolic syndrome is a better predictor of heart attack or stroke than the sum of the risk factors. You could even argue that there is really no such thing as metabolic syndrome – it is just a list of risk factors!

To try to clarify matters, a number of leading medical organizations, like the International Diabetes Foundation and the World Heart Federation, have got together to produce a single definition of metabolic syndrome. The key elements are: increased waist circumference (the exact cutoff depending on the population and country involved), triglycerides 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, or less than 50 mg/dL (1.3 mmol/L) in women, blood pressure greater or equal to 130/85 mm Hg and fasting glucose level equal to or more than 100 mg/dL (5.5mmol/L). If you ‘know your numbers’, check this out. Do you have metabolic syndrome?

In a recent discussion of this new definition, a group of international experts argue that the great underlying factor in metabolic syndrome is central obesity (‘fat round the middle’) which leads to insulin resistance and the clustering of risk factors. Weight loss, therefore, may be the key to reducing metabolic syndrome and research has shown that losing weight by calorie control, drugs and surgery can all reduce both insulin resistance and metabolic syndrome. Moreover, metabolic syndrome can be prevented by long-term physical activity. The experts also mention the thiazolidinediones, a group of non-insulin drugs used in type 2 diabetes. These act on fat cells and thereby reduce insulin resistance and metabolic syndrome. There is much more to be learned about metabolic syndrome and the role it plays in setting up the body for long-term health problems. Till then, lifestyle modification aimed at reducing central obesity is the best way of warding off metabolic syndrome.

Source:

Antonova P et al The metabolic syndrome The Lancet January 16 2010;375:181-183