Obesity & Metabolic Syndrome -- January 19, 2009 -- Dr. Sonal Gupta - NewsChannel5.com | Nashville News, Weather & Sports

Metabolic Syndrome

Metabolic syndrome is the name for a group of risk factors linked to overweight and obesity that increase your chance for heart disease and other health problems such as diabetes and stroke. The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are behaviors or conditions that increase your chance of getting a disease.

The five conditions listed below are metabolic risk factors for heart disease. A person can develop any one of these risk factors by itself, but they tend to occur together. Metabolic syndrome is diagnosed when a person has at least three of these heart disease risk factors:

• A large waistline. This means that you carry excess weight around your waist (abdominal obesity). Your doctor will measure your waist to determine whether you have abdominal obesity. A waist measurement of 35 inches or more for women and 40 inches or more for men is a component of metabolic syndrome and indicates an increased risk for heart disease and other health problems. A large waistline also is the same as "having an apple shape."
• A higher than normal triglyceride level, or you are on medicine to treat high triglycerides. Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dl or higher is a component of metabolic syndrome.
• A lower than normal level of HDL cholesterol (high-density lipoprotein cholesterol), or you are on medicine to treat low HDL. HDL is considered "good" cholesterol because it lowers your chances of heart disease. An HDL cholesterol level less than 50 mg/dl for women and less than 40 mg/dl for men is a component of metabolic syndrome.
• Higher than normal blood pressure, or you are on medicine to treat high blood pressure. A blood pressure of 130/85 or higher is a component of metabolic syndrome. If only one of your two blood pressure numbers is high, it's still a risk factor for metabolic syndrome.
• Higher than normal fasting blood sugar (glucose), or you are on medicine to treat high blood sugar. A normal fasting blood sugar is less than 100 mg/dl. Fasting blood sugar between 100 and 125 mg/dl is considered pre-diabetes. Fasting blood sugar of 126 mg/dl or higher is considered diabetes. A fasting blood sugar of 100 mg/dl or higher (pre-diabetes or diabetes) is a component of metabolic syndrome.

The more of these risk factors you have, the greater your chance of developing heart disease, diabetes or stroke. In general, a person with metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone without metabolic syndrome.

Other risk factors aside from those of the metabolic syndrome also increase your risk for heart disease. A high level of LDL cholesterol (low-density lipoprotein cholesterol; considered "bad" cholesterol) and smoking, for example, are key risk factors for heart disease, but they aren't components of metabolic syndrome. Even a single risk factor raises your risk for heart disease, and every risk factor should be lowered to reduce the risk.

The chance of developing metabolic syndrome is closely linked to being overweight or obese and to a lack of physical activity. Another cause is insulin resistance. Insulin resistance is a condition in which the body can't use its insulin properly. Insulin is a hormone the body uses to help change blood sugar into energy. Insulin resistance can lead to high blood sugar levels and is closely linked with being overweight or obese.

Genetics (ethnicity and family history) and older age are other important underlying causes of metabolic syndrome.

How Is Metabolic Syndrome Treated?

Healthy lifestyle changes are the first line of treatment for metabolic syndrome. Lifestyle changes include weight loss, increased physical activity, an improved diet and quitting smoking.

Medicines are the next line of treatment. They're used to treat and control individual risk factors such as high blood pressure, high triglycerides, low HDL cholesterol (high-density lipoprotein cholesterol), and high blood sugar. Medicines such as aspirin also may be used to reduce the risk of blood clots, a condition that often occurs with metabolic syndrome.

Outlook

About 47 million adults in the United States (almost 25 percent) have metabolic syndrome, and the numbers continue to grow. The increasing number of people with this condition is connected to the rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease.

It's possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome takes a long-term effort and teamwork with your health care providers.