The Metabolic Syndrome (MetS)
WHAT IS THE "METABOLIC SYNDROME"?
Metabolic Syndrome (MetS) is a set of risk factors which significantly increase the chance of developing diabetes, heart disease, and stroke. Proper dietary changes, weight loss and exercise may help improve and defer Metabolic Syndrome, and perhaps even reverse its process. Other names given to this condition include insulin resistance syndrome, dysmetabolic syndrome, and Syndrome X. According to a US national health survey (NHANES 1988-2012), more than 1 in 5 Americans have Metabolic Syndrome. Its incidence increases with age, and among those in their 60s and 70s, it affects more than 40%. For the Asia-Pacific region, in a systematic review it has been noted that "in most countries nearly 1/5th of the adult population or more were affected by Metabolic Syndrome with a secular increase in prevalence." A systematic review done among the young in 2020 showed that globally, about 3% of children and 5% of adolescents had Metabolic Syndrome, with some variation across countries and regions.
Based on WHO estimates, Metabolic Syndrome and all its associated complications cause the greatest number of non-communicable disease deaths worldwide. To make the long story short, METABOLIC SYNDROME is the No. 1 killer in the world today! We all have to wake up to the truth: it is an URGENT PROBLEM the whole world is currently facing!
WHO TYPICALLY HAS THE "METABOLIC SYNDROME"?
People with type 2 diabetes mellitus (T2DM) or a strong family history of T2DM
People with central obesity/visceral adiposity (increased fat in the abdomen/waist)
People who have cardiovascular disease (such as coronary artery disease or CAD and myocardial infarction or “heart attack”)
People who have cerebrovascular disease or stroke or “brain attack” (both ischemic stroke and hemorrhagic stroke)
People with other clinical features of "insulin resistance" including skin changes of acanthosis nigricans ("darkened skin" on the back of the neck or underarms) or skin tags (usually on the neck), polycystic ovarian syndrome (PCOS), and fatty liver changes
Certain ethnic backgrounds are at a higher risk of developing Metabolic Syndrome
WHAT CAUSES THE "METABOLIC SYNDROME"?
As of the present, the exact cause of Metabolic Syndrome is not yet totally known. However, a lot of its features are associated with "insulin resistance" or “carbohydrate intolerance.” Insulin resistance is a state wherein certain cells of the body (e.g. the muscle cell) do not efficiently use insulin for glucose uptake. Thus, high blood glucose levels persist, and some of them are converted to triglycerides in the liver, which leads to non-alcoholic fatty liver disease (NAFLD), and with excess triglycerides going to the bloodstream elevating the triglyceride levels in the blood. Insulin resistance may be due to a combination of genetic and lifestyle factors. Included among these lifestyle factors are dietary habits (especially diets high in refined carbohydrates such as sugars and flour-containing products and habitual frequent eating especially with carbohydrate-rich foods even when not hungry) that lead to chronic excessive glucose levels beyond what the body demands for its energy needs, lack of regular physical activity/exercise and perhaps even interrupted sleep patterns (such as that seen in sleep apnea) or lack of sufficient restful sleep.
WHAT ARE THE SYMPTOMS OF THE "METABOLIC SYNDROME"?
There are usually no immediate physical symptoms in metabolic syndrome. However, medical problems associated with the insulin resistance of this syndrome and its corresponding complications may develop over time and themselves present with clinical symptoms. Your health care provider who is familiar with metabolic syndrome will make the diagnosis by obtaining the necessary tests, including blood pressure monitoring, waist circumference monitoring, blood glucose, serum insulin, and lipid profile (triglycerides and HDL).
HOW IS THE "METABOLIC SYNDROME" DIAGNOSED?
Metabolic Syndrome is diagnosed if you have any three or more of the following five criteria from the U.S. National Heart, Lung, and Blood Institute (NHLBI) and the American Heart Association (AHA):
ABDOMINAL OBESITY/ADIPOSITY: Waistline of ≥ 40 in/102 cm (in men) and ≥ 35 in/88 cm (in women) as measured across the belly [for Asians (IDF 2005): ≥ 35.4 in/90 cm (in men) and ≥ 31.5 in/80 cm (in women)]
HIGH BLOOD PRESSURE: Blood pressure ≥ 130/85 mm Hg (or already taking blood pressure/hypertension medications)
HIGH TRIGLYCERIDES: Triglyceride (TG) level ≥ 150 mg/dl (or already taking hypertriglyceridemia medications)
HIGH BLOOD SUGAR: Fasting blood glucose/sugar (FBS) level ≥ 100 mg/dl (or already taking glucose-lowering medications)
LOW HDL: High density lipoprotein (HDL) level < 40 mg/dl (in men) or < 50 mg/dl (in women) (or already taking treatment for reduced HDL)
WHAT TESTS CAN YOU REQUEST YOUR DOCTOR TO PERFORM TO HELP YOU FIND OUT IF YOU HAVE THE "METABOLIC SYNDROME"?
HOW TO PREVENT, IMPROVE OR REVERSE THE "METABOLIC SYNDROME"?
WHAT ARE SPECIFIC WAYS TO REDUCE YOUR RISK OF OR REVERSE THE PROCESS LEADING TO THE "METABOLIC SYNDROME"?
FOR PATIENTS WITH THE "METABOLIC SYNDROME" WHAT HEALTH PROBLEMS MIGHT DEVELOP?
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