The Diagnosis of Metabolic Syndrome
and Its Effects on the Body
Davis & Elkins College
The Diagnosis of Metabolic Syndrome
and Its Effects on the Body
Metabolic syndrome is characterized by a grouping of factors that indicate a dysfunctional metabolism that can lead to deadly diseases. Metabolic syndrome links individuals with heart disease to not only high cholesterol, but also hypertension, belly fat, and high blood sugar CITATION Eug l 1033 (Killoran, n.d.). The National Heart, Lung, and Blood Institute states, “Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease” (n.d.). Another alarming statistic is that more and more children, especially children that are overweight, are being diagnosed with metabolic syndrome (Killoran, n.d.).
Metabolic syndrome represents a complex grouping of cardiovascular disease risks. The “disease of modern civilization” affects 25% of adult Americans and millions of adults in Western industrialized countries CITATION McA16 l 1033 (McArdle, Katch, & Katch, 2016). 40% of people over the age of 60 are affected by metabolic syndrome CITATION DrA l 1033 (Axe, n.d.). Metabolic syndrome places individuals at higher risk of cardiovascular disease, diabetes, stroke, and other diseases related to fatty buildup in the walls of the arteries. Obesity, physical inactivity, genetic factors, and aging can all be underlying causes of metabolic syndrome CITATION Ame16 l 1033 (American Heart Association , 2016). Some racial and ethnic groups in the United States are at higher risk for metabolic syndrome. Mexican Americans have the highest rate of metabolic syndrome (National Heart, Lung, and Blood Institute, n.d.). Some other groups that are at an increased risk for metabolic syndrome are people with a personal history of diabetes and those who have an intermediate family member with diabetes (National Heart, Lung, and Blood Institute, n.d.).
For years, type 2 diabetes and insulin resistance had been studied but the concept of metabolic syndrome was introduced at the annual meeting of The American Diabetes Association by Reaven in 1988. He initially called it “Syndrome X” and defined insulin resistance “as the dominant underlying risk factor that leads to progressively disrupted metabolism” CITATION Ame09 l 1033 (American College of Preventitive Medicine , 2009).
According to the American Heart Association, to be diagnosed with metabolic syndrome doctors look for the presence of three or more of these risk factors:
Central or abdominal obesity, measured by waist circumference:
Men- greater than 40 inches
Women- greater than 35 inches
Triglycerides greater than or equal to 150mg/dL
Men- less than 40mg/dL
Women- less than 50 mg.dL
Blood pressure greater than or equal to 130/85 mmHg
Fasting glucose greater than or equal to 100mg/dL
The chance for future cardiovascular disease is greater when an individual suffers these conditions together than when any one factor is presented alone. High blood pressure by itself is dangerous for the body, but when an individual has high blood pressure, raised fasting glucose levels, and abdominal obesity they are diagnosed with metabolic syndrome; and are ultimately at a much higher risk for cardiovascular disease CITATION Ame16 l 1033 (American Heart Association , 2016). An individual’s risk for heart disease, diabetes, and stroke increases as the number of metabolic risk factors increases CITATION Nat l 1033 (National Heart, Lung, and Blood Institute, n.d.).
Metabolic syndrome is also associated with insulin resistance, a generalized metabolic disorder. Insulin resistance prevents people from using insulin efficiently CITATION Ame16 l 1033 (American Heart Association , 2016). The International Diabetes Federation claims that insulin resistance occurs when the cells in the body lose sensitivity to insulin, the hormone responsible for glucose absorption, and eventually become resistant (2006). A buildup of sugar in the blood is caused by the cells not being able to absorb glucose. This then triggers hyperinsulinemia, the increasing production of insulin weakens and can wear out the beta cells. Once the pancreas has reached the point of no longer being able to produce enough insulin, a person becomes hyperglycemic and is diagnosed with type 2 diabetes CITATION IDF06 l 1033 (IDF Communications, 2006). Ultimately insulin resistance leads to raised blood glucose levels and is closely linked with obesity CITATION Nat l 1033 (National Heart, Lung, and Blood Institute, n.d.).
Excessive fat in and around the abdomen is a significant potential cause of metabolic syndrome. Obesity is linked with metabolic syndrome and insulin resistance. It contributes to high blood pressure, high cholesterol, hyperglycemia, and is independently related to higher risk of cardiovascular disease CITATION IDF06 l 1033 (IDF Communications, 2006). Obesity and inactivity can both be the cause of insulin resistance CITATION Ame09 l 1033 (American College of Preventitive Medicine , 2009). Eugenia Killoran talks about the fat cells that are wrapped around the organs and are very active, “They pump out hormones and other chemicals that raise blood pressure, worsen cholesterol levels, slow down our metabolism, and foul up the delicate system by which insulin works, causing insulin resistance” (n.d.). The chemicals secreted by belly fat can also trigger inflammation throughout the body, which is linked to higher risk of heart attacks, strokes, osteoarthritis, and Alzheimer’s disease CITATION Eug l 1033 (Killoran, n.d.).
The medical problems associated with metabolic syndrome develop over time and usually no physical symptoms are present CITATION Cle17 l 1033 (Cleveland Clinic, 2017). However, a large waistline is a visible sign and can be measured by the patient themselves. If abdominal obesity is a factor, then blood pressure, blood glucose, triglycerides, and HDL cholesterol should all be tested to check for the risk of metabolic syndrome CITATION IDF06 l 1033 (IDF Communications, 2006).
An article posted by the Cleveland Clinic discusses the health problems that might develop from having metabolic syndrome. It states that “consistently high levels of insulin and glucose are linked to many harmful changes in the body” (2017). These harmful changes can cause damage to the lining of the coronary and other arteries, which is a key factor towards developing heart disease or stroke. It can cause damage to the kidneys, which can impair their ability to remove salt, leading to high blood pressure CITATION Cle17 l 1033 (Cleveland Clinic, 2017). Individuals with metabolic syndrome that have increased triglyceride levels have an increased risk of developing cardiovascular disease. There is also an increased risk of blood clot formation that can block arteries and cause heart attacks. Another significant problem that may arise with metabolic syndrome is the slowing of insulin production which can signal the start of type 2 diabetes CITATION Cle17 l 1033 (Cleveland Clinic, 2017).
Type 2 diabetes alone is associated with an increased risk for cardiovascular disease and stroke, but this risk is multiplied when included with the factors of metabolic syndrome CITATION Cle17 l 1033 (Cleveland Clinic, 2017). Uncontrolled or untreated diabetes can lead to complications that impact the eyes, mouth, kidneys, nerves, and extremities CITATION McA16 l 1033 (McArdle, Katch, & Katch, 2016). According the National Heart, Lung, and Blood Institute, “about 85% of people who have type 2 diabetes-the most common type of diabetes- also have metabolic syndrome. These people have a much higher risk for heart disease than the 15 percent of people who have type 2 diabetes without metabolic syndrome” (n.d.). Current trends in childhood and adult obesity show that the prevalence of type 2 diabetes and its complications will only continue to increase CITATION Ame04 l 1033 (American Cancer Society, the American Diabetes Association, and the American Heart Association, 2004).
Metabolic syndrome requires long-term management of each risk factor and regular monitoring of blood pressure, cholesterol, and glucose. Poor nutrition and lack of physical activity represent the underlying cause of these risk factors; therefor to treat metabolic syndrome one must lose weight, increase physical activity, and eat a healthy diet CITATION McA16 l 1033 (McArdle, Katch, & Katch, 2016). The National Heart, Lung, and Blood Institute states that “the major goal of treating metabolic syndrome is to reduce the risk of coronary heart disease” (n.d.). The two objectives with managing metabolic syndrome include reducing the underlying cause, obesity and lack of physical activity, and then to treat the risk factors associated with it CITATION Ame09 l 1033 (American College of Preventitive Medicine , 2009). The first line treatment is lifestyle therapy because it improves every aspect of metabolic syndrome. The goal of the treatment is to slow down or prevent cardiovascular disease and type 2 diabetes from developing CITATION Ame09 l 1033 (American College of Preventitive Medicine , 2009).
The American College of Preventative Medicine states that “just becoming less sedentary has a positive effect on the syndrome” (2009). According to Dr. Axe, “A loss of just 3 percent to 5 percent of your current body weight can lower your triglycerides, blood glucose and the risk of developing type 2 diabetes” (n.d.). The greater the amount of weight the individual loses the more improved their risk factors will be. In 2017, a study highlighted that an hour of weekly resistance exercise portrayed a 29% lower risk of developing metabolic syndrome, compared to those with no resistance exercise. Those who combined aerobic exercise with their resistant exercise displayed a 25% lower risk CITATION DrA l 1033 (Axe, n.d.). The optimal diet for preventing and treating metabolic syndrome is one that focuses on foods that are low in calorie density and naturally high in fiber and nutrients” (Killoran, n.d.). Some foods that worsen metabolic syndrome include fake and processed foods, artificial sweeteners, trans-fats, refined carbohydrates and sugars, and alcohol CITATION DrA l 1033 (Axe, n.d.).
There are currently no drugs specifically made to treat metabolic syndrome, but drugs for insulin resistance and metabolic syndrome are being studied CITATION Ame09 l 1033 (American College of Preventitive Medicine , 2009). Instead it is necessary to treat the individual risk factors of the syndrome in order to lower the overall risk associated with each factor that will then reduce the overall impact of cardiovascular disease and the risk of type 2 diabetes CITATION IDF06 l 1033 (IDF Communications, 2006). There are effective drug therapies for the following risk factors: prevention of type 2 diabetes and hyperglycemia, dyslipidemia, high blood pressure, increased coagulation, and decreased fibrinolysis CITATION Ame09 l 1033 (American College of Preventitive Medicine , 2009). According to the American College of Preventative Medicine, “Pharmacologic therapy for lipids and blood pressure, at minimum, will eventually be needed for most people with metabolic syndrome” (2009).
The metabolic syndrome has received increased attention in the past few years. It consists of multiple, interrelated risk factors of metabolic origin that appear to directly promote the development of atherosclerotic cardiovascular disease (ASCVD) CITATION Ame05 l 1033 (American Heart Association/National Heart, Lung, and Blood Institute, 2005) can be precipitated by multiple underlying risk factors. The most important of these underlying risk factors are abdominal obesity and insulin resistance
This finding implies that the metabolic syndrome imparts a relatively high long-term risk for both ASCVD and diabetes.
Not a disease per se
BIBLIOGRAPHY American Cancer Society, the American Diabetes Association, and the American Heart Association. (2004, June 28). Preventing Cancer, Cardiovascular Disease, and Diabetes. Retrieved from Professional Heart Daily : http://circ.ahajournals.org/content/109/25/3244
American College of Preventitive Medicine . (2009). Metabolic Syndrome Clinical Reference Page . Retrieved from American College of Preventitive Medicine : http://www.acpm.org/?Metabolic_ClinRef
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American Heart Association/National Heart, Lung, and Blood Institute. (2005, October 24). Diagnosis and Management of the Metabolic Syndrome. Retrieved from Professional Heart Daily : http://circ.ahajournals.org/content/112/17/e285.full
Axe, D. (n.d.). Metabolic Syndrome: Proven Diet & Natural Treatment Plan. Retrieved from Dr. Axe Food is Medicine : https://draxe.com/metabolic-syndrome/
Cleveland Clinic. (2017, November 27). Metabolic Syndrome. Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/10783-metabolic-syndrome
IDF Communications. (2006). The IDF Consensus Worldwide Definition of the Metabolic Syndrome . International Diabetes Federation .
Killoran, E. (n.d.). Metabolic Syndrome Diet & Lifestyle Recommendations. Retrieved from Pritikin Longevity Center + Spa : https://www.pritikin.com/your-health/health-benefits/reverse-metabolic-syndrome/1381-metabolic-syndrome-cleaning-up-a-mess.html
McArdle, W. D., Katch, F. I., & Katch, V. L. (2016). Essentials of Exercise Physiology. Wolters Kluwer .
National Heart, Lung, and Blood Institute. (n.d.). Metabolic Syndrome. Retrieved from National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov/health-topics/metabolic-syndrome