Metabolic Syndrome

What is metabolic syndrome?

A syndrome is a cluster of findings that, when they occur together, are defined as a specific disease state or disorder. There are several different definitions of metabolic syndrome but the most common involves the following five criteria:

Elevated blood pressure ≥ 130/85 mmHg

Elevated fasting blood glucose ≥100 mg/dL

Low HDL cholesterol <40 mg/dL

Elevated triglycerides ≥150 mg/dL

Elevated waist circumference ≥ 90 to 102cm in males or 80 to 88cm in females (cutoffs vary by ethnicity)

In order to diagnose metabolic syndrome, at least three of these five criteria must be present.

The prevalence of metabolic syndrome in the US is quite high. It is estimated that 1/3 of US adults probably meet the criteria for diagnosis. It has also been estimated that only 12% of people in the US are within the optimal range for all five metrics. The presence of metabolic syndrome is associated with an increased risk for cardiovascular disease, diabetes and other health problems.

There is some disagreement on whether or not metabolic syndrome as a whole carries more risk than what would be conferred by the sum of the risks of each  individual component. This is one reason why some have argued that it should not be defined as a separate disease entity.  However, detecting the presence of either metabolic syndrome or the presence of its individual components is important as it provides an opportunity to address the risk factors present.

Treatment consists of lifestyle changes to address the underlying causes of the disorder and, if necessary, therapies targeted at the individual components present.  A lifestyle-based approach includes nutrition, physical activity and some or all of the other four pillars of lifestyle medicine outlined in an earlier post.

It is becoming increasingly recognized that many in the US are suffering from poor metabolic health and the problems associated with this. The five metrics comprising the metabolic syndrome are easily measured. They provide a useful framework for detecting compromised metabolic health and enacting a treatment plan aimed at reversing it.

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