Metabolic syndrome is a cluster of conditions — increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes.

Having just one of these conditions doesn't mean you have metabolic syndrome. However, any of these conditions increase your risk of serious disease. If more than one of these conditions occur in combination, your risk is even greater.

If you have metabolic syndrome or any of the components of metabolic syndrome, aggressive lifestyle changes can delay or even prevent the development of serious health problems.

Most of the disorders associated with metabolic syndrome have no symptoms, although a large waist circumference is a visible sign. If your blood sugar is very high, you might experience signs and symptoms of diabetes — including increased thirst and urination, fatigue, and blurred vision.

When to see a doctor

If you know you have at least one component of metabolic syndrome, ask your doctor whether you need testing for other components of the syndrome.

Metabolic syndrome is primarily caused by obesity and inactivity.

Metabolic syndrome is linked to a condition called insulin resistance. Normally, your digestive system breaks down the foods you eat into sugar (glucose). Insulin is a hormone made by your pancreas that helps sugar enter your cells to be used as fuel.

In people with insulin resistance, cells don't respond normally to insulin, and glucose can't enter the cells as easily. As a result, glucose levels in your blood rise despite your body's attempt to control the glucose by churning out more and more insulin.

This can eventually lead to diabetes when your body is unable to make enough insulin to keep the blood glucose within the normal range.

The following factors increase your chances of having metabolic syndrome:

  • Age. Your risk of metabolic syndrome increases with age, affecting 40 percent of people over the age of 60.
  • Race. Hispanics and Asians seem to be at greater risk of metabolic syndrome than are people of other races.
  • Obesity. Carrying too much weight increases your risk of metabolic syndrome — particularly if you have an apple shape rather than a pear shape.
  • Diabetes. You're more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.
  • Other diseases. Your risk of metabolic syndrome is higher if you've ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome.

Having metabolic syndrome can increase your risk of developing these conditions:

  • Diabetes. If you don't make lifestyle changes to control your insulin resistance, your glucose levels will continue to increase. You may develop diabetes as a result of metabolic syndrome.
  • Cardiovascular disease. High cholesterol and high blood pressure can contribute to the buildup of plaques in your arteries. These plaques can cause your arteries to narrow and harden, which can lead to a heart attack or stroke.

You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a doctor who specializes in diabetes (endocrinologist) or in heart disease (cardiologist).

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance. This might include restricting your diet, such as for a fasting blood sugar test or a cholesterol test.
  • Make a list. Write down your symptoms and a list of all the medications and supplements you're taking regularly.
  • Record your family medical history. In particular, note any relatives who have had diabetes, heart attacks or strokes.
  • Take a family member or friend along. Sometimes it can be difficult to recall all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Several organizations have criteria for diagnosing metabolic syndrome. According to guidelines used by the National Institutes of Health, you have metabolic syndrome if you have three or more of these traits:

  • Large waist circumference. This is defined as a waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men.
  • High triglyceride level. Count this trait on your checklist if your triglyceride level is at least 150 milligrams per deciliter, or mg/dL, (1.7 millimoles per liter, or mmol/L), or if you're receiving treatment for high triglycerides.
  • Reduced HDL cholesterol. Tally another mark on your checklist if your levels of this "good" cholesterol are less than 40 mg/dL (1.04 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women, or if you're receiving treatment for low HDL.
  • Increased blood pressure. This condition is met if you are taking blood pressure medications or if your blood pressure is at least 130/85 millimeters of mercury (mm Hg).
  • Elevated fasting blood sugar. Count this trait if you have a blood sugar level of at least 100 mg/dL (5.6 mmol/L) or if you take medications to control your high blood sugar.

If aggressive lifestyle changes aren't enough, your doctor might suggest medications to help control your blood pressure, cholesterol levels and blood glucose.

Aggressive lifestyle changes are usually required to prevent serious health problems, such as diabetes and heart disease. These changes include:

  • Exercise. Doctors recommend getting 30 or more minutes of moderate-intensity exercise, such as brisk walking, every day.
  • Lose weight. Losing weight can reduce insulin resistance and blood pressure and decrease your risk of diabetes.
  • Eat healthy. The Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, like many healthy-eating plans, limit unhealthy fats and emphasize fruits, vegetables, fish and whole grains. Both of these dietary approaches have been found to offer important health benefits — in addition to weight loss — for people who have components of metabolic syndrome.
  • Stop smoking. Smoking cigarettes worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.
Aug. 22, 2014