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Metabolic syndrome, also called syndrome X or insulin resistance syndrome, refers to a combination of metabolic risk factors that increase the chance of developing cardiovascular diseases, such as heart attacks or strokes; and type 2 diabetes.
Metabolic syndrome is diagnosed when a patient has at least three of the following:
- A waistline of 40 inches or more for men, or 35 inches or more for women;
- A systolic blood pressure above 130 and a diastolic blood pressure above 85 mmHg, or if the patient is taking blood pressure-lowering medications;
- A fasting blood sugar level above 100 mg/dL, or if the patient is taking glucose-lowering medications;
- A triglyceride level greater than 150 mg/dL;
- An HDL level of less than 40 mg/dL for men, or 50 mg/dLfor women.
Metabolic syndrome, in turn, has its own set of underlying risk factors, of which insulin resistance is most important. Insulin resistance is when the body’s cells do not respond well to insulin and therefore cannot use glucose; glucose stays in the blood, causing high blood sugar levels while the cells are deprived of nutrition. Insulin resistance can be acquired, hereditary, or mixed. Other risk factors include abdominal obesity, physical inactivity, aging, hormonal imbalances, and use of certain medications. Women are more susceptible than men. Some racial and ethnic groups are at higher risk than others.
Metabolic syndrome is often associated with excessive blood clotting and chronic low-grade inflammation, as well as several other conditions, but the cause-effect relationship is not clear.
The goal of treating metabolic syndrome is to reduce the risk of cardiovascular diseases. Treatment aims to lower blood pressure and cholesterol; and to manage diabetes, or prevent it, if it hasn’t already developed.
Lifestyle changes include a heart-healthy diet, physical activity plan, weight management, stress management, and quitting smoking.
If lifestyle changes aren’t enough, medications may be prescribed to lower LDL cholesterol and triglycerides; to reduce blood pressure, blood sugar level, or to prevent blood clots.