Metabolic Syndrome

Metabolic Syndrome

 

Metabolic Syndrome is a cluster of cardiovascular factors which may indicate an increased risk for developing cardiovascular disease (CVD) and diabetes.

Epidemiology

  • Incidence – 40-50 million people in the U.S.
  • Age – increased incidence with age
    • Low incidence in persons <30 years old
    • ≥50% incidence in persons >60 years old
  • Sex – equal between males and females

Risk Factors

  • Abdominal obesity
  • Polycystic Ovarian Syndrome (PCOS)
  • Older age
  • Insulin resistance
  • Genetics

Pathophysiology

  • Insulin resistance is thought to represent most of the underlying pathophysiology
  • Development of obesity and physical inactivity lead to insulin resistance
  • Proinflammatory and prothrombotic state with glucotoxicity and lipotoxicity contributes to metabolic and vascular abnormalities

Clinical Presentation

  • Obesity
  • Diabetes
  • Hyperlipidemia
  • Hypertension

Diagnosis

  • Definition (requires 3 of 5 criteria) National Cholesterol Education Program ATP III
    • Waist circumference ≥40 inches (men); ≥35 inches (women)
    • Triglyceride level ≥150 mg/dL
    • HDL <40 mg/dL (men); <50 mg/dL (women)
    • Hypertension (BP ≥130/85)
    • Fasting blood glucose ≥100 mg/dL

Click here for chart of Criteria for Major Definitions of the Metabolic Syndrome


  • Laboratory testing
    • Fasting Blood Sugar
    • Lipid Panel

Treatment

  • Blood pressure reduction measures
  • Diet and exercise with weight loss
  • May require antihypertensives and lipid lowering agents

See Also