Metabolic syndrome: What you need to know

Metabolic syndrome: What you need to know

Metabolic syndrome refers to a series of risk factors for disease that tend to increase the risk of type 2 diabetes and cardiovascular disease. It is also known as the condition of insulin resistance.

The syndrome is not a medical condit brings together a variety of risk factors with a greater probability of developing cardiovascular disease and type 2 diabetes.

Metabolic syndrome is defined by the American Heart Association ( AHA) as a cluster of metabolic disorders, including high blood pressure , high fasting glucose levels, and abdominal obesity, which together increase the risk of heart disease.


A doctor will consider a range of factors before diagnosing metabolic syndrome.
A doctor will consider a range of factors before diagnosing metabolic syndrome.

According to the AHA, if a person has at least three of the following five symptoms, a doctor will also consider metabolic syndrome:

  1. Central, visceral, abdominal obesity, specifically, a waist size of more than 40 inches in men and more than 35 inches in women
  2. Fasting blood glucose levels of 100 mg/dL or above
  3. Blood pressure of 130/85 mm/Hg or above
  4. Blood triglycerides levels of 150 mg/dL or higher
  5. High-density lipoprotein (HDL) cholesterol levels of 40 mg/dL or less for men and 50 mg/dL or less for women

A greater risk of cardiovascular disorders such as heart attack or stroke and type 2 diabetes is indicated by having three or more of these factors.


Initially, diagnosis attempts to classify certain individuals who may be at risk of metabolic syndrome, but who may benefit from behavioral changes rather than drug therapies.

Through lifestyle measures, elevated blood glucose levels, high blood pressure, and lipid and cholesterol irregularities can also be targeted early.

However, some people can still use medicine for some aspects of metabolic syndrome before they are diagnosed, such as high blood pressure.

Losing weight can be an efficient therapy, especially in the upper body.

Suggested prevention and treatment steps for abnormal cholesterol and other forms of metabolic syndrome involve

  • eating a “heart-healthy diet” that is low in sugar, fat , and sodium.
  • taking regular exercise
  • avoiding smoking and reducing alcohol intake

Each week, the AHA suggests doing at least 150 minutes of moderate exercise. These can be broken up into 10-minute sessions. A good way to start is by brisk walking.

Drug treatment

If drug treatment is recommended, this is usually with metformin.

This will assist some at-risk groups , especially individuals with high levels of blood glucose and those on the obesity continuum who are not manageable with changes in diet and lifestyle.

Metformin is sold in the U.S. under these brand names:

  • Fortamet
  • Glucophage
  • Glumetza
  • Riomet

In people who have a high risk of diabetes due to metabolic syndrome, the drug is not legally approved for preventive use.

Some physicians do, however, recommend ‘off-label’ metformin to avoid diabetes in people with high glucose levels and abdominal obesity. Diabetes specialists and clinical trial evidence support this use.

A research published in 2013 concluded that metformin is important to reduce the risk of diabetes in adults with risk factors, but that diet and exercise changes are “ approximately twice as effective.

Other drugs, such as statins in people with high levels of low-density lipoprotein ( LDL ) cholesterol, may also be used in the treatment of metabolic syndrome.

For the treatment of high blood pressure, antihypertensive drugs are used.

Again, lifestyle measures are tried first or in low-risk groups.


In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.


To avoid and treat metabolic syndrome, the DASH diet is recommended. The aim of the diet is hypertension prevention.

It recommends:

  • choosing foods from healthful sources
  • limiting intake of red meats, sodium, saturated fats and total fats, and sweetened foods and drinks
  • consuming plenty of fruits and vegetables, wholegrains, fish, and nuts

The DASH diet focuses on what people eat rather than how to reduce calories, although the diet can be practiced at a lower calorie amount by those who want to lose weight.


Not all medical standards agree on the precise thresholds for a metabolic syndrome diagnosis to be used.

Controversy remains, for instance, about the best way to measure and define obesity. Options include body mass index ( BMI), height-waist ratio, or other means. For instance , a person may also have high blood pressure or high blood glucose, which is not linked to obesity.

In an effort to harmonize diagnostics, the above requirements were established. Doctors will also consider the circumstances of an individual, however.

Metabolic syndrome and childhood obesity

Along with early obesity, dyslipidemia, and high blood pressure, metabolic syndrome, often abbreviated to MetS, may start in childhood.

Some have called for early screening to identify those with a higher cardiovascular risk, leading to concerns about the increase in obesity among young people in recent years.

This could encourage improvements to a healthy lifestyle to be targeted and the risk of health issues to be decreased later in life.

However, it remains controversial how and when to test for and diagnose metabolic syndrome and obesity in kids. One theory is that rising children show wide variation in these variables.

According to the Centers for Disease Control (CDC), almost 1 in 5 young people aged 6 to 19 years currently live with obesity in the United States overall, three times the amount in the 1970s. When they reach adulthood, these individuals may be at risk of developing health issues.


Metabolic syndrome is a set of risk factors, so there is not a single cause.

A major cause is central obesity or obesity, but abnormal levels of blood fats and cholesterol , high blood pressure, and prediabetes also lead to cardiometabolic risk.

Big waistlines
Big waistlines indicate high central obesity, a major cardiometabolic risk factor.

The probability of acquiring certain components may be increased by inevitable risk factors, such as family history and ethnic background.

Nevertheless, lifestyle decisions will influence all these considerations.

The development of obesity and related disorders has been associated with a diet that is high in fat and sugar, along with a lack of exercise.

Signs like insulin resistance, however, do not usually follow obesity or suggest metabolic syndrome.

Insulin resistance, which can lead to cardiovascular disease and type 2 diabetes, is a feature of metabolic syndrome and obesity, but it can also be a sign of other conditions. Examples include Cushing ‘s disease, nonalcoholic fatty liver disease, polycystic ovary syndrome ( PCOS), and chronic kidney disease.

Low-level inflammation and blood clotting abnormalities are other complications that are occasionally associated with metabolic syndrome, insulin resistance , and high blood sugar. These can also lead to cardiovascular disease growth.

Risk factors

The following factors increase the risk of metabolic syndrome development:

  • a large waistline
  • a family history of metabolic syndrome
  • a lack of exercise combined with a high-calorie diet
  • insulin resistance
  • the use of some medications

Find out more from the following Nccmed pages:

  • How much should I weigh? This article includes information on various measures of obesity, including BMI, waist-to-hip ratio and body fat percentage.