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Metabolic syndrome

Metabolic syndrome is a name for a group of risk factors that occur together and increase the chance of having coronary artery disease, stroke, and type 2 diabetes.

Causes

Metabolic syndrome is becoming very common in the United States. Doctors are not sure whether the syndrome is due to one single cause. But all of the risks for the syndrome are related to obesity.

The two most important risk factors for metabolic syndrome are:

  • Extra weight around the middle and upper parts of the body (central obesity). This body type may be described as "apple-shaped."
  • Insulin resistance. Insulin is a hormone produced in the pancreas. Insulin is needed to help control the amount of sugar in the blood. Insulin resistance means that some cells in the body use insulin less effectively than normal. As a result, blood sugar level rises, which causes insulin to rise. This may increase the amount of body fat.

Other risk factors include:

  • Aging
  • Genes that make you more likely to develop this condition
  • Changes in male, female, and stress hormones
  • Lack of exercise

People who have metabolic syndrome often have one or more other factors that may be linked with the condition, including:

  • Increased risk of blood clotting
  • Increased levels of blood substances that are a sign of inflammation throughout the body
  • Small amounts of a protein called albumin in the urine

Exams and Tests

Metabolic syndrome is present if you have three or more of the following signs:

  • Blood pressure equal to or higher than 130/85 mmHg
  • Fasting blood sugar (glucose) equal to or higher than 100 mg/dL
  • Large waist circumference (length around the waist): For men, 40 inches or more; for women, 35 inches or more
  • Low HDL (good) cholesterol: For men, 40 mg/dL or less; for women, 50 mg/dL or less 
  • Triglycerides equal to or higher than 150 mg/dL

Treatment

The goal of treatment is to reduce your risk of heart disease and diabetes.

Your doctor will recommend lifestyle changes or medicines:

Your doctor may recommend daily low-dose aspirin.

If you smoke, now is the time to quit.

Outlook (Prognosis)

People with metabolic syndrome have an increased long-term risk of developing heart disease, type 2 diabetes, stroke, kidney disease, and poor blood supply to the legs.

When to Contact a Medical Professional

Call your health care provider if you have signs or symptoms of this condition.

Alternative Names

Insulin resistance syndrome; Syndrome X

References

Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention: National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640-1645.

Gallagher EJ, LeRoith D, Karnielli E. The metabolic syndrome--from insulin resistance to obesity and diabetes. Med Clin N Am. 2011;95:855-873.

Rosenzweig JL, Ferrannini E, Grundy SM, et al. Primary prevention of cardiovascular disease and type 2 diabetes in patients at metabolic risk: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93:3671-3689.

Update Date: 8/5/2014

Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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