Metabolic Syndrome

Medical Author: Ruchi Mathur, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.
Medical Reviewing Editor: William C. Shiel Jr, MD, FACP, FACR

• What is metabolic syndrome?
• How is metabolic syndrome defined?
• How common is metabolic syndrome?
• What causes metabolic syndrome?
• Why should I know about metabolic syndrome?
• How is metabolic syndrome treated?
• Summary

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 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. Please see Insulin Resistance article for more information.

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:

• 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.

2. Cholesterol panel showing a triglyceride level of at least 150 mg/dl or an HDL cholesterol lower than 35 mg/dl.
3. Blood pressure of 140/90 or above (or on treatment for high blood pressure).

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