Metabolic syndrome

Metabolic syndrome, also known as syndrome X or insulin resistance syndrome, is a collection of conditions that together increases the risk of developing heart disease or type 2 diabetes. These conditions include an increased waistline, hypertension (high blood pressure), increased blood sugar levels, high amounts of triglycerides and low levels of high density lipoprotein (HDL), also known as 'good' cholesterol, in the blood.

Metabolic syndrome is common in Australia, with around one in five people meeting the criteria for diagnosis. Metabolic syndrome can affect both men and women and becomes more common as people get older.

Causes

The cause of metabolic syndrome is generally lifestyle related, including eating an unhealthy diet and lack of exercise. In some cases, genetic factors can also play a part.

Signs and symptoms

Obesity is the main obvious sign of metabolic syndrome. The other conditions generally do not show specific signs and symptoms, even when at dangerous levels. If you have consistently high blood sugar levels, you may experience an increase in thirst. Hypertension can cause dull headaches, dizzy spells or nosebleeds if it has reached a dangerously high level for an extended period of time.

Methods for diagnosis

Metabolic syndrome can be diagnosed by your doctor using a physical examination and blood tests to assess for each of the conditions that are associated with the disorder. A diagnosis is made if you are obese and any two of either a high blood sugar level, a high triglyceride level, hypertension or low HDL cholesterol level. Tests include:

• A measurement of waist circumference. As a general guide, if your waist measurement is more than 94-102cm for men and 80cm for women, you have an increased risk of metabolic syndrome;
• A blood pressure test where a reading higher than 130/85 indicates you have hypertension;
• A blood test to check the level of fasting blood sugar, which can be taken before breakfast. A result greater than 5.6 mmol/L indicates a high level of blood sugar;
• A blood test to check the levels of triglycerides - a result higher than 1.7 mmol/L indicates a high level of triglycerides, and;
• A blood test to check the level of high density lipoprotein (HDL). A result of less than 1 mmol/L for men and 1.3 mmol/L for women indicates a low level of HDL.

A blood test can be used to check sugar and lipid levels in the blood. 

Types of treatment

Treatment of metabolic syndrome involves lifestyle changes to become healthier. These include:

• Weight loss;
• Regular exercise. A good goal is to do at least 30 minutes of exercise on most days of the week;
• Eating less by reducing the portion sizes of main meals and avoiding snacking throughout the day;
• Eating healthily, which includes plenty of fruits and vegetables, lean meats and dairy products (mostly reduced fat);
• Limiting refined sugar found in sweets and sugary drinks;
• Drinking plenty of water - at least 6-8 glasses a day for adults;
• Reducing saturated fats by limiting fatty or processed foods;
• Improving cholesterol levels by eating nuts, fish and other foods that contain omega-3 fatty acids;
• Reducing stress;
• Not smoking, and;
• Reducing alcohol intake.

In some cases, diet and lifestyle changes are not enough and medication may be required to lower blood pressure or reduce the amount of triglycerides in the blood. Your doctor will be able to recommend which medication is needed to treat the various features of metabolic syndrome.

Exercise can help to reduce the risk of, as well as treat, metabolic syndrome. 

Potential complications

The long-term complications of metabolic syndrome are heart disease and type 2 diabetes.

Heart disease

Heart disease, also known as cardiovascular disease, includes coronary artery disease, which is the formation of fat deposits inside the blood vessels of the heart. Heart disease can lead to angina, heart attack and death.

Type 2 diabetes

Type 2 diabetes is a chronic condition that affects the ability of your body to control the level of sugar in the blood. The condition can be effectively managed, but has complications including heart disease, nerve damage and kidney disease.

Prognosis

The outlook for people with metabolic syndrome is good if action is taken to address each feature of the syndrome to reach the recommended healthy targets.

Prevention

Metabolic syndrome is almost always preventable. Prevention involves maintaining a healthy weight, eating nutritious food, limiting fatty or sugar-filled foods and exercising regularly. It is also important to have regular health checks to monitor blood pressure, blood sugar and blood triglyceride levels. This will allow your doctor to identify any abnormal results and suggest a treatment plan to bring your results into a healthy range.

Eating a wide variety of healthy foods can help to prevent metabolic syndrome.