Metabolic Syndrome: Signs, Symptoms, & Treament

A cell is the smallest, most basic unit of life, that is capable of existing by itself. The obesity in people with

metabolic syndrome is typically in the upper body or belly area. People who are 35 to 40% over their ideal

body weight generally have up to a 40% decrease in insulin sensitivity. Up to 50% of people with people

with high blood pressure have insulin resistance.

HYPERINSULINEMIA: Too much insulin in the body. See above for a description of insulin. In the case of

metabolic syndrome, there is too much insulin in the body because the pancreas (a long organ in the back

of the belly) produces more of it when the body resists its effects. The increased insulin is what leads

many of the other abnormalities that are present in this condition. For example, too much insulin prevents

fat cells from giving up their energy stores to let us lose weight.

BLOOD CLOTTING ABNORMALITIES: Blot clotting is when blood fluid comes together as a solid. This is

caused by abnormalities in the blood.

INCREASED CATECHOLAMINE LEVELS: Catecholamines are types of chemical substances that are

released in the body in response to stress. An example of a type of catecholamine is adrenaline.

HYPERGLYCERIDEMIA: Too many glycerides (a type of fatty chemical) in the body. Fatty substances

increase in the blood in response to increased insulin. For example, increased amounts of insulin cause

the liver to make increased amounts of triglycerides (a type of fat). The liver is the largest organ in the

body and is responsible for filtering (removing) harmful chemical substances, producing important

chemicals for the body, and other important functions. The excess triglycerides build up in the belly area

and cause increased weight gain. Excess triglycerides also decrease the ability of the body to produce

good cholesterol. Cholesterol is a waxy, fatty substance found only in animal tissues. Good cholesterol

helps to eliminate bad cholesterol. See below for more information on good and bad cholesterol.

WHAT ARE SOME MORE DETAILS ON HOW INSULIN WORKS?

Insulin is normally released from the pancreas when the body detects a rise of glucose in the blood. This

usually happens a few minutes after every meal. Insulin normally helps store glucose and amino acids for

the energy needs of cells, such as muscle cells. Amino acids are a group of chemical substances that

form proteins. When insulin stores glucose in the liver, it changes it to a type of carbohydrate known as

glycogen. Carbohydrates are a group of substances present in certain types of foods (such as sugar) that

provides the body with energy. Insulin also helps prevent the formation of glucose from substances that

are not carbohydrates, such as proteins.

Since insulin helps store glucose, it helps the body tolerate glucose. Glucose tolerance is said to be

normal if a rise in glucose causes a release of insulin, which takes glucose into cells. In metabolic

syndrome, one problem is that glucose tolerance is impaired to the point that it threatens and impairs

health.

WHO GETS METABOLIC SYNDROME?

The people who are most at risk for metabolic syndrome are those who lead inactive lives and who go on

to become obese (very overweight). People who have lots of fat in the belly area are especially prone to

developing metabolic syndrome. It is also believed that metabolic syndrome runs in families. Minorities,

such as African-Americans, Asians, Hispanics, and Native Americans are at risk for developing metabolic

syndrome.

People who have a history of Type II diabetes (see above), high levels of fat in the blood, or high blood

pressure are at risk for developing metabolic syndrome. People who have parents, brothers, or sisters

with diabetes are also at risk for metabolic syndrome. People with a skin condition called acanthosis

nigricans are at risk for developing metabolic syndrome. Acanthosis nigricans is a darkened, velvety

thickening of the skin. Almost 90% of women with these skin changes have insulin resistance. These skin

changes are usually present at the neck and body folds. Both dark skinned and light skinned people can

get this skin condition. The condition improves with better diet and weight loss.

People with gestational diabetes are also at risk for developing metabolic syndrome. Gestational diabetes

is a condition in which women develop intolerance to glucose during pregnancy. This intolerance is usually

first recognized during the time between the 28th week of pregnancy and birth. After giving birth, the levels

of glucose usually become normal again, but may remain impaired or develop into diabetes mellitus (see

above).

Women with polycystic ovaries are also prone to getting metabolic syndrome. Polycystic ovary syndrome

is a disturbance characterized by too much hair growth, an inability to produce children, anovulation, and

amenorrhea. Ovaries are organs in the female body that normally produce eggs. Anovulation is when

these eggs are not produced or not released by the ovaries. Amenorrhea is not menstruating, which is a

when the female reproductive organ bleeds and releases unneeded tissues.

WHAT SHOULD I BE MOST CONCERNED ABOUT IF I HAVE METABOLIC SYNDROME?

The main concerns are that metabolic syndrome puts people at an extremely high risk for heart disease,

blood vessel disease, and premature death (dying too early). However, aggressive treatment can

successfully decrease the risk of life-threatening complications from metabolic syndrome.

HOW MANY PEOPLE HAVE METABOLIC SYNDROME?

According to the Centers for Disease Control, it is estimated that approximately one in five people in the

United States have metabolic syndrome. One in four people past the age of 60 have it. Overall, that

comes to approximately 47 million Americans who have this problem. This information was published in the

January 16, 2002 edition of the Journal of the American Medical Association.

IS METABOLIC SYNDROME MORE COMMON IN MEN OR WOMEN?

Metabolic syndrome is more common in men.

WHERE IS METABOLIC SYNDROME THE MOST COMMON?

Metabolic syndrome is most common in Western countries, such as the United States, and not as

common in Eastern countries such as China or India.

IS METABOLIC SYNDROME A NEW MEDICAL CONDITION?

Metabolic syndrome has been around for thousands of years, however, it never had a name. It was not

until 1988 that it was recognized that all of the disorders that make up this condition fits into its own

syndrome. A syndrome is a group of signs and symptoms that occur together and have a common cause,

representing a certain disease or inherited (passed on from the parents' biological makeup) abnormality. A

sign is clear evidence of disease that can be measured or seen (unlike a symptom), such as a fever or a

rash. A symptom is an indication of a disease or a change in condition that is reported by the patient but

is not observed by others.

HOW IS METABOLIC SYNDROME TREATED?

Treatment of metabolic syndrome involves treating all of the symptoms present in a given person. Luckily,

what treats one symptom of metabolic syndrome is usually good at treating the others. As was mentioned

earlier, aggressive treatment can successfully decrease the risk of life-threatening complications from

metabolic syndrome. Although there are medications that can be used to treat aspects of metabolic

syndrome (such as using the medication, Glucophage, to decrease insulin resistance), there is no magic

pill that can be taken to make metabolic syndrome go away. See the end of this section for more

information on medications for metabolic syndrome.

Since insulin resistance is the cause of the problems in metabolic syndrome, it makes sense that

treatment would focus on decreasing insulin resistance. The best treatment for this is a proper diet,

exercise, and weight loss. Specifically, people with metabolic syndrome should try to get their weight down

to within 20 percent of what their weight should be, based on height and age. Losing 16% of one's body

weight improves the body's ability to use glucose by 100%. Exercise should consist of 30 minutes of

sustained walking a day.

The diet should be low in calories and low in cholesterol. Cholesterol is a waxy, fatty substance found only

in animal tissues. The diet should be high in fruits vegetables, and dietary fiber. Dietary fiber is a term for

chemical substances in the cells of plants that cannot be digested by the human body. Dietary fiber adds

bulk (mass) to the diet and helps prevent disease of the intestine and the colon. High levels of dietary fiber

can be found in oats, peas, beans, prunes, brussels sprouts, cabbage, and sweet potatoes. Dietary fiber

slows the increase in blood sugar when you eat so it helps to decrease insulin resistance.

Many doctors advise that diets high in refined carbohydrate should be avoided. Carbohydrates are a

group of substances present in certain types of foods (such as sugar) that provides the body with energy.

Refined carbohydrates are those in which the nutrients have been removed. Eating a lot of carbohydrates

causes the insulin level to rise, which in turn, makes sugar levels rise. Since there is already too much

insulin in people with metabolic syndrome, eating too many carbohydrates will just add to the increase in

blood sugar levels. Foods with lots of carbohydrates include sugary foods, sodas, breads, pasta, and

potatoes. Complex carbohydrates, such as beans, grains, and vegetables are better to eat because the

nutrients have not been removed.

Saturated fats should be avoided. Saturated means to be filled up with something. In the case of fats,

saturated refers to how much hydrogen (a kind of element) is contained in it. Saturated fats are filled with

hydrogen and are the most harmful to eat. Foods with lots of saturated fats are fried foods, cookies,

crackers, pastries, movie popcorn, and many types of stick margarines or butters. The amount of

saturated fat is located on the food label. Eating white meat chicken (without the skin), fish, lean meats,

and nonfat dairy products is good for you.

Eating more monosaturated fats and polyunsaturated fats is a good way to partially treat metabolic

syndrome. Monosaturated fat has only one gap in it where there is no hydrogen. Polyunsaturated fat has

many gaps in it where there is no hydrogen and comes mainly from plants. Foods with monostaurated and

polyunsaturated fats include nuts, avocados, nut butters, seeds, fish, olive oil, and canola oil.

Weight loss and exercise also do a good job of treating the high levels of fatty substances in the blood.

One important goal is to reduce the levels of LDL. LDL stands for low-density lipoprotein cholesterol. LDL

is called the "bad cholesterol" because it can cause cholesterol to build up, which can lead to blockage of

the arteries. Arteries are blood vessels that pump blood away from the heart. When LDL levels are

reduced, the goal is to reduce the level of triglycerides (a type of fat) in the blood and to raise the HDL

level. HDL stands for high-density lipoprotein cholesterol. HDL is called the "good cholesterol" because it

helps prevent cholesterol from building up in your arteries.

Reducing fatty substances and cholesterol in the blood can be achieved with medications as well. These

are usually used in people who cannot lower their cholesterol with diet and exercise. Doctors usually

prescribe medications known as statins (such as Lipitor) to lower cholesterol. Statins block an enzyme the

body needs to make cholesterol. An enzyme is a type of protein that helps produce chemical reactions in

the body. Other medications are also used to reduce cholesterol and fat in the blood. Medications such as

Glucophage, Rezulin, and Precose can improve the body's sensitivity to insulin by decreasing the amount

of glucose in the blood. If you have metabolic syndrome, ask your doctor which medication is right for you.

People with metabolic syndrome also need to stop smoking. Smoking makes insulin resistance worse and

it decreases the levels of good cholesterol in the blood. It also increases high blood pressure and the

amount of fatty substances in the blood. Too much alcohol use can also have the same effect as smoking.

However, moderate alcohol use (no more than a drink a day for women) can decrease insulin resistance

and the amount of fatty substances in the blood.

To help prevent blood clots from forming, patients with metabolic syndrome are often given aspirin

because aspirin thins the blood. For those who have high blood pressure, diet, exercise, weight loss, and

medication management can be useful forms of treatment as well.

CAN METABOLIC SYNDROME BE PREVENTED?

Yes. Metabolic syndrome can most often be prevented with exercise, a proper diet, and weight loss.

WHO DISCOVERED METABOLIC SYNDROME?

It was not until 1988 that Dr. Gerald Reaven, a professor of medicine at Stanford University School of

Medicine, first used the term "syndrome x" to describe the disorders present in this condition.

WHAT ELSE IS METABOLIC SYNDROME KNOWN AS?

Metabolic syndrome is also known as insulin resistance syndrome, metabolic syndrome X, syndrome X,

the Pluri-Metabolic syndrome, and the Deadly Quartet.

WHAT IS THE ORIGIN OF THE TERM, METABOLIC SYNDROME?

Metabolic comes from the Greek word "metabole" meaning "change," and the Greek work "ikos" meaning

"pertaining to." Syndrome comes from the Greek word "syn" meaning "together," and the Greek word

"dromos" meaning "course." Put the words together and you get "pertaining to change course together."