Metabolic
Syndrome / Syndrome X
What is it?
Metabolic syndrome
is a set of risk factors that includes: abdominal
obesity, a decreased ability to process glucose (insulin
resistance), dyslipidemia (unhealthy lipid
levels), and hypertension. Patients who have this
syndrome have been shown to be at an increased risk
of developing
cardiovascular disease and/or
type 2 diabetes. Metabolic syndrome is a common
condition that goes by many names (dysmetabolic
syndrome, syndrome X, insulin resistance syndrome,
obesity syndrome, and Reaven’s syndrome), but few
outside the medical community have heard of it. Most
patients have been educated about the importance of
checking their
cholesterol levels, watching for signs of
diabetes, having their blood pressure monitored, and
exercising – but there has been little to tie all of
these factors together except pursuit of a
"healthier lifestyle."
The World Health
Organization (WHO) was the first to publish an
internationally accepted definition for metabolic
syndrome in 1998, but the criteria that have
received the most widespread acceptance and use are
those proposed as part of ATP III (the third report
of the National Cholesterol Education Program expert
panel on Detection, Evaluation, and Treatment of
High Blood Cholesterol in Adults). ATP III defines
metabolic syndrome as involving three or more of the
following:
Central/abdominal
obesity as measured by waist circumference [Men -
Greater than 40 inches (102 cm); Women - Greater
than 35 inches (88 cm)]
Fasting triglycerides greater than or equal to
150 mg/dL (1.69 mmol/L)
HDL cholesterol [Men - Less than 40 mg/dL (1.04
mmol/L); Women - Less than 50 mg/ dL (1.29 mmol/L)]
Blood pressure greater than or equal to 130/85 mm Hg
Fasting glucose greater than or equal to 110 mg/dL
(6.1 mmol/L)
Also frequently
seen with metabolic syndrome but not included with
the ATP III criteria are prothrombotic (blood
clotting) and proinflammatory tendencies. While
these combined criteria and risk factors do not
usually cause overt symptoms, they are a warning of
an increased likelihood of clogged arteries,
heart disease,
stroke, diabetes,
kidney disease, and even premature death. If
left untreated, complications from untreated
metabolic syndrome can develop in as few as 15
years. Those patients who have metabolic syndrome
and also smoke tend to have an even poorer
prognosis.
In the U.S., it is
estimated that 20% of adults (about 47 million) have
metabolic syndrome, with the prevalence approaching
50% in the elderly. It can affect anyone at any age,
but it is most frequently seen in those who are
significantly overweight (with most of their excess
fat in the abdominal area) and inactive.
The root cause of
most cases of metabolic syndrome can be traced back
to poor eating habits and a sedentary lifestyle.
Some cases occur in those already diagnosed with
hypertension and in those with poorly controlled
diabetes; a few are thought to be linked to genetic
factors that are still being researched.
All of the factors
associated with metabolic syndrome are interrelated.
Obesity and lack of exercise tend to lead to insulin
resistance. Insulin resistance has a negative effect
on lipid production, increasing VLDL (very
low-density lipoprotein), LDL (low-density
lipoprotein – the “bad” cholesterol), and
triglyceride levels in the bloodstream and
decreasing HDL (high-density lipoprotein – the
“good” cholesterol). This can lead to fatty plaque
deposits in the arteries which, over time, can lead
to cardiovascular disease, blood clots, and strokes.
Insulin resistance also leads to increased insulin
and glucose levels in the blood. Excess insulin
increases sodium retention by the kidneys, which
increases blood pressure and can lead to
hypertension. Chronically elevated glucose levels in
turn damage blood vessels and organs, such as the
kidneys, and may lead to diabetes.
[For
a more detailed explanation,
click here].
http://www.labtestsonline.org/understanding/conditions/metabolic.html