What is Metabolic Syndrome and why is it important?

Metabolic syndrome is a collection of disorders that strike together and increase your risk of developing type 2 diabetes or cardiovascular disease (stroke or heart disease). The causes of metabolic syndrome are complex and not well understood, but there is thought to be a genetic link. Being overweight or obese and physically inactive adds to your risk. Metabolic syndrome is sometimes called syndrome X or insulin-resistance syndrome.

As we get older, we tend to become less active and may gain excess weight. This weight is generally stored around the abdomen, which can lead to the body becoming resistant to the hormone insulin. This means that insulin in the body is less effective, especially in the muscles and liver.

More than 35% of Australian adults have metabolic syndrome. This is higher in people with diabetes.

The main benefit of the detection of the Metabolic syndrome is its focus on central obesity and preventive interventions to address this as well as hyper-insulinaemia.

Diagnosis of the Metabolic syndrome is based on meeting three of five criteria (central obesity(excess fat in and around the stomach (abdomen), high triglyceride level, low high density lipoprotein cholesterol (HDL), high blood pressure and high fasting glucose level).

Measuring your waist circumference is a key part of the assessment.

As a general rule, if your waist measures 94 cm or more (men) or 80 cm or more (women), you probably need to lose some weight. Men from Middle Eastern, South Asian, Chinese, Asian-Indian, South and Central American ethnic backgrounds are considered at risk if their waist measures 90 cm or more.

Certain medical conditions are highly associated with metabolic syndrome like polycystic ovarian syndrome and obstructive sleep apnea.

Treatment should focus firstly on increasing physical activity and reducing weight

Can it be prevented?

Metabolic syndrome can be avoided by interventions that modify diet and physical activity and control weight. Physical activity is especially important. The risk of metabolic syndrome is reduced by increased leisure time physical activity, especially higher intensity activities such as fast walking or jogging. It is increased by sedentary behavior such as watching television, especially in older patients. Interventions in childhood and adolescence, including reduction in screen time and increased participation in sporting activities, may decrease the likelihood of the Metabolic Syndrome developing later in life.

Treatment should focus firstly on increasing physical activity and reducing weight. There is no specific pharmacotherapy. Treatment should focus on management of individual risk factors such as lipids, blood pressure and glucose. However, care needs to be taken not to accelerate weight gain and reduce capacity for physical activity.

Smoking increases your risk of cardiovascular disease, stroke, cancer and lung disease. Quitting will have many health benefits, especially if you have metabolic syndrome.

Dr Nada Rawof
13 March 2016