Metabolic Syndrome

In recent years, health experts have become increasingly interested in a collection of risk factors known as metabolic syndrome. They have found that people with metabolic syndrome are at an elevated risk for developing cholesterol deposits in the walls of the arteries (atherosclerosis), which causes most heart attacks and strokes. Metabolic syndrome also raises the risk of developing type 2 diabetes.

Because these illnesses are among the leading causes of death in the United States, preventing or treating the individual conditions that make up metabolic syndrome could save many lives. People may be diagnosed with metabolic syndrome if they have three or more of the following conditions:

• Increased abdominal fat: a waist circumference greater than 40 inches for men or 35 inches for women
• Elevated blood pressure on several measurements: 130 mm Hg or greater systolic (top number) or 85 mm Hg or greater diastolic (bottom number)
• Elevated level of triglycerides (blood fats): 150 mg/dl or higher after a 12-hour fast
• Low level of HDL (the "good") cholesterol: lower than 50 mg/dl for men or 45 mg/dl for women
• Elevated blood sugar levels: 110 mg/dl or greater after a 12-hour fast

While researchers are still investigating why these factors often occur together, they suspect a gradual resistance to insulin in the body may be to blame. Insulin is a hormone that helps the body's cells use the glucose supplied by food. If the body doesn't use insulin efficiently, cells can't take up as much glucose, so it accumulates in the blood. In response, the body makes more insulin, overloading the blood. As a result of the excess insulin, triglycerides and other fats build up in the blood, increasing the risk of abnormal cholesterol. At the same time, kidneys become strained by the additional load, leading to high blood pressure.

In some cases, the cause of insulin resistance may be genetic or environmental. But most of the time, overweight and inactivity seem to be the culprit. Metabolic syndrome occurs in only 5 percent of adults of normal weight but in 22 percent of those who are overweight and 60 percent of those who are obese. Lifestyle changes such as losing excess weight, exercising, and quitting smoking can help to prevent or treat metabolic syndrome. If you suspect you're at risk, ask your doctor to evaluate you for this serious condition.