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Metabolic Syndrome

Medical Author: Ruchi Mathur, M.D.
Medical Editor: William C. Shiel Jr, MD, FACP, FACR

Weight Management and Control

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Weight management is one lifestyle change you can make to prevent or manage metabolic syndromeA lifestyle that combines sensible eating with regular physical activity is the key to good health.

To be at their best, adults need to avoid gaining weight, many need to lose weight and some are underweight. Being overweight or obese increases your risk for high blood pressure, heart disease, stroke, diabetes, arthritis, and breathing problems. A healthy weight is key to a long, healthy life.

Evaluate Your Body

If you are an adult, find out your BMI (click here for calculations). Not all adults who have a BMI in the range labeled "healthy" are at their most healthy weight. For example:

  • Some may have lots of fat and little muscle.
  • A BMI above the healthy range is less healthy for most people; but it may be fine if you have lots of muscle, a large body frame, and little fat.
  • The further your BMI is above the healthy range, the higher your weight-related risk. If your BMI is above the healthy range, you may benefit from weight loss, especially if you have other health risk factors.
  • BMIs slightly below the healthy range may still be healthy unless they result from illness.

What is metabolic syndrome?

An association between certain metabolic disorders and cardiovascular disease has been known since the 1940s. In the 1980s this association became more clearly defined and the term metabolic syndrome (also known as syndrome X or the dysmetabolic syndrome) was coined to designate a cluster of metabolic risk factors that come together in a single individual. In more current times, the term metabolic syndrome is found throughout medical literature and in the lay press as well. There are slight differences in the criteria of diagnosis - depending on which authority is quoted. Regardless, the concept of a clustering of risks factors leading to cardiovascular disease is well accepted.

The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese.

Insulin resistance refers to the diminished ability of cells to respond to the action of insulin in promoting the transport of the sugar glucose, from blood into muscles and other tissues. Because of the central role that insulin resistance plays in the metabolic syndrome, a separate article is devoted to insulin resistance.

How is metabolic syndrome defined?

The definition of metabolic syndrome depends on which group of experts is doing the defining. Based on the guidelines from the 2001 National Cholesterol Education Program Adult Treatment Panel (ATP III), any three of the following traits in the same individual meet the criteria for the metabolic syndrome:

  1. Abdominal obesity: a waist circumference over 102 cm (40 in) in men and over 88 cm (35 inches) in women.

  2. Serum triglycerides 150 mg/dl or above.

  3. HDL cholesterol 40mg/dl or lower in men and 50mg/dl or lower in women.

  4. Blood pressure of 130/85 or more.

  5. Fasting blood glucose of 110 mg/dl or above. (Some groups say 100mg/dl)

The World Health Organization (WHO) has slightly different criteria for the metabolic syndrome:

  1. High insulin levels, an elevated fasting blood glucose or an elevated post meal glucose alone with at least 2 of the following criteria:

  2. Abdominal obesity as defined by a waist to hip ratio of greater than 0.9, a body mass index of at least 30 kg/m2 or a waist measurement over 37 inches.

  3. Cholesterol panel showing a triglyceride level of at least 150 mg/dl or an HDL cholesterol lower than 35 mg/dl.

  4. Blood pressure of 140/90 or above (or on treatment for high blood pressure).



Next: How common is metabolic syndrome? »

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Metabolic Syndrome

What is insulin resistance?

Insulin is a hormone that is produced by the beta cells, which are cells that are scattered throughout the pancreas. The insulin produced is released into the blood stream and travels throughout the body. Insulin is an important hormone that has many actions within the body. Most of the actions of insulin are directed at metabolism (control) of carbohydrates (sugars and starches), lipids (fats), and proteins. Insulin also is important in regulating the cells of the body including their growth.

Insulin resistance (IR) is a condition in which the cells of the body become resistant to the effects of insulin, that is, the normal response to a given amount of insulin is reduced. As a result, higher levels of insulin are needed in order for insulin to have its effects. The resistance is seen with both the body's own insulin (endogenous) and if insulin is given through injection (exogenous).

What cause...

Read the Insulin Resistance article »








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