Metabolic syndrome is a group of conditions that together raise your risk of coronary heart disease, diabetes, stroke, and other serious health problems. Metabolic syndrome is also called insulin resistance syndrome.
You may have metabolic syndrome if you have three or more of the following conditions.
- A large waistline: This is also called abdominal obesity or “having an apple shape.” Extra fat in your stomach area is a bigger risk factor for heart disease than extra fat in other parts of your body.
- High blood pressure: If your blood pressure rises and stays high for a long time, it can damage your heart and blood vessels. High blood pressure can also cause plaque, a waxy substance, to build up in your arteries. Plaque can cause heart and blood vessel diseases such as heart attack or stroke.
- High blood sugar levels: This can damage your blood vessels and raise your risk of getting blood clots. Blood clots can cause heart and blood vessel diseases.
- High blood triglycerides: Triglycerides are a type of fat found in your blood. High levels of triglycerides can raise your levels of LDL cholesterol, sometimes called bad cholesterol. This raises your risk of heart disease.
- Low HDL cholesterol, sometimes called good cholesterol: Blood cholesterol levels are important for heart health. “Good” HDL cholesterol can help remove “bad” LDL cholesterol from your blood vessels. “Bad” LDL cholesterol can cause plaque buildup in your blood vessels.
What causes metabolic syndrome?
A person’s weight is a major cause of metabolic syndrome. Fat cells, especially in your abdomen, can raise your levels of chemicals called free fatty acids. Free fatty acids can raise your levels of other chemicals and hormone that affect the way your body controls your blood sugar levels. Your body may not respond well to insulin, which is a hormone that controls how much sugar your muscles and organs absorb from your blood. This is called insulin resistance.
Free fatty acids and insulin resistance can raise your “bad” LDL cholesterol and lower your “good” HDL cholesterol. Insulin resistance can also raise your blood pressure and blood triglyceride levels.
Also, cells from your immune system can cause your extra fat cells to make chemicals that increase inflammation in your body. This inflammation can cause plaque, a waxy substance, to build up inside your blood vessels. Plaque can break off and block your blood vessels. Inflammation itself also causes insulin resistance, high blood pressure, and heart and blood vessel diseases.
If you have metabolic syndrome, your symptoms will depend on which of the five conditions you have. Some symptoms can be seen, while others are not as obvious. For example, you or your healthcare provider may notice that you have a large waistline. However, high blood pressure, high blood triglycerides, and low HDL cholesterol, or “good” cholesterol, usually do not cause any symptoms.
High blood sugar may cause the following symptoms:
- Blurred vision
- Increased thirst
- Increased urination, especially at night
- Tiredness and weakness
To diagnose metabolic syndrome, your provider will ask whether you or others in your family have any symptoms or risk factors. They may also ask you about your diet and whether you exercise regularly.
During your physical exam, your provider will measure your waist. You may have abdominal obesity, one of the conditions of metabolic syndrome, if your waist measures more than 40 inches for men and 35 inches for women. Your provider may use different measurement values for diagnosis, depending on your race and ethnicity.
Diagnostic tests and procedures
To diagnose metabolic syndrome, your provider will check your blood pressure and do blood tests to measure your blood sugar, cholesterol, and triglyceride levels.
- For most adults, a healthy blood pressure is less than 120/80 mm Hg (millimeters of mercury — the units used to measure blood pressure).
- You may have high blood pressure, one of the conditions of metabolic syndrome, if your blood pressure is consistently 130/85 mmHg or higher.
- A healthy blood sugar level for adults after 8 to 12 hours of fasting (not eating) is between 70 and 99 mg/dL (milligrams per deciliter — the units used to measure blood sugar, triglycerides, and cholesterol).
- If your fasting blood sugar level is between 100–125 mg/dL, you have high blood sugar levels or prediabetes.
- If your fasting blood sugar level is 126 mg/dL or higher, you may have diabetes, a condition of metabolic syndrome. Also, you may have metabolic syndrome if you are taking medicines to treat high blood sugar or diabetes.
- HDL cholesterol, or “good” cholesterol, levels of 60 mg/dL and above can help lower your risk of heart disease.
- You may have high blood cholesterol, one of the conditions of metabolic syndrome, if your HDL cholesterol levels are lower than 50 mg/dL for women and lower than 40 mg/dL for men.
- Healthy blood triglyceride levels are less than 150 mg/dL for adults.
- You may have high blood triglycerides, one of the conditions of metabolic syndrome, if your triglyceride levels are consistently more than 150 mg/dL.
Children who have metabolic syndrome can also have these conditions. Your child’s provider will determine the measures and cutoff numbers for your child.
The main goals of treating metabolic syndrome are to lower your risk of heart disease and to prevent type 2 diabetes if it hasn’t already developed. If you already have type 2 diabetes, treatment can lower your risk of heart disease by controlling all your risk factors.
Heart-healthy lifestyle changes are the first line of treatment for metabolic syndrome. You may have to see a dietitian and a physical therapist to help find a diet and exercise plan that works for you. If healthy lifestyle changes do not work, you may need medicines or weight loss surgery.
You may also need treatment for other health conditions that caused your metabolic syndrome or can make it worse.
Healthy lifestyle changes
The heart-healthy lifestyle changes listed below can help you control your risk factors and prevent complications.