Metabolic syndrome

Metabolic syndrome is a cluster of conditions that put you at higher risk of coronary heart disease (CHD), which occurs when your heart’s blood supply is blocked by a build-up of fatty substances in the coronary arteries.

Definitions vary, but the symptoms are broadly all connected with being overweight, having high blood pressure and/or diabetes. With metabolic syndrome, you're three times more likely to have a heart attack or stroke, and twice as likely to die from it than those who don’t have it. Around one in four people in the UK have this condition.

Causes

Although there isn’t one single cause of metabolic syndrome, there are common lifestyle factors that increase the risk. Being overweight or obese - particularly if you have excess fat around your waist - with an inactive lifestyle, is one contributing factor.

Insulin resistance (sometime called pre-diabetes), when your body can’t use the hormone insulin and blood sugar remains high over a prolonged period, is also a major risk factor.

If you have insulin resistance there will be too much glucose in your bloodstream, and this can lead to you developing type 2 diabetes, as well as raising your risk of heart disease. If you have had a family history of insulin resistance, this can also increase your risk of metabolic syndrome.

Symptoms

Metabolic syndrome symptoms include: a body mass index of 30 or more or central obesity; low levels of 'good' HDL cholesterol (which helps to remove cholesterol from the arteries); high levels of triglyceride fats (a fat in the blood); insulin resistance, diabetes or high-fasting blood glucose levels; and high blood pressure.

The British Heart Foundation says if you have three or more of these factors then you have metabolic syndrome.

Some of these conditions, such as high blood pressure, cholesterol and triglyceride levels, have no symptoms, but central obesity is obvious from your appearance.

Insulin resistance symptoms include: lethargy; hunger; difficulty concentrating; high blood pressure; hyper-pigmentation (darkening of skin pigment) and skin tags. If you’re diabetic, you may have symptoms of high blood sugar, such as an increased thirst, urinating more often (especially at night), fatigue and blurred vision. There may also be no symptoms present.

Diagnosis

Your doctor will perform several diagnostic tests and, if you are found to have three or more of the risk factors, you’ll be diagnosed as having metabolic syndrome.

Warning signs include a waist circumference of 94cm (37 inches) or more for European men, or 90cm (35.5 inches) or more in South Asian men; and 80cm (31.5 inches) or more in European and South Asian women.

Blood pressure is monitored to see if it’s consistently over 140/90mmhg. Blood tests to check glucose in your blood and look for signs of insulin deficiencies/resistance or diabetes will aslo be taken. Blood tests will also check your triglyceride and HDL levels.

Who gets metabolic syndrome?

Metabolic syndrome is common in people who are overweight. It's more common in Asian and African-Caribbean population and it can also occur in overweight children.

You're also more at risk of metabolic syndrome if you have cardiovascular disease, non-alcoholic fatty liver disease (where there’s a build-up of fatty acids in the liver) and polycystic ovary syndrome (PCOS) <>, which affects a women’s ovaries.

Treatments

Changing to a healthier lifestyle can reduce the risk of CHD and prevent the onset of type 2 diabetes. Your doctor may recommend you lose weight, exercise regularly, eat a healthy well-balanced diet, quit smoking and reduce alcohol consumption.

They may also prescribe drugs to help control blood pressure, such as angiotensin-converting enzyme (ACE) inhibitors which reduce blood pressure by relaxing your blood vessels; statins to lower low-density lipoprotein (LDL) ' bad' cholesterol; and metformin to improve insulin sensitivity.

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn’t possible supplements can help. This article isn’t intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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