Metabolic syndrome overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]

Overview

Metabolic syndrome are characterized by a cluster of conditions that greatly increases the risk of a person to develop heart diseases, diabetes and stroke. By definition one is said to have a metabolic syndrome if they have 3 of the following 5 conditions: high blood pressure (>130/85), abnormal fasting blood glucose > 100 mg/dl, increased weight around the waist (women > 35 inches, male > 40 inches), triglycerides > 150 mg/dl and a low HDL (female < 50, male < 40).

Historical Perspective

The term "metabolic syndrome" dates back to at least the late 1950s, but came into common usage in the late 1970s to describe various associations of risk factors with diabetes, that had been noted as early as the 1920s.

Pathophysiology

The pathophysiology is extremely complex and has only been partially elucidated. Most patients are older, obese, sedentary, and have a degree of insulin resistance. The most important factors in order are 1) aging, 2) genetics and 3) lifestyle (i.e., decreased physical activity and excess caloric intake).

Causes

Metabolic syndrome is becoming more and more common in the United States. Researchers are not sure whether the syndrome is due to one single cause, but all of the risks for the syndrome are related to obesity.

Differentiating Metabolic Syndrome from other Diseases

Metabolic syndrome occurs in the presence of insulin resistance and accompanying obesity. It increases the risk for coronary heart disease,diabetes, fatty liver, stroke and some cancers. It may manifests as hypertension, hyperglycemia, hypertriglyceridemia, reducedhigh-density lipoprotein cholesterol. The differential diagnosis includes chronic liver disease, cushing syndrome and congenital adrenal hyperplasia with overlapping presentations.

Epidemiology and Demographics

The prevalence of metabolic syndrome has increased over the decades. The prevalence are higher in western countries, with increasing ages and in certain races like Mexican-Americans and African-Americans.

Risk Factors

Most common risk factors include central obesity, insulin resistance and aging.