Metabolic Syndrome: The Five Measurements, Risks and Next Steps

What it involves

MedlinePlus defines metabolic syndrome as a group of risk factors that occur together and raise the chance of coronary artery disease, stroke, and type 2 diabetes. It says about one in three Americans is affected and that the risk rises with age.

Who this is for

• Patients who have been told they have prediabetes, mild high blood pressure, or high triglycerides at the same time
• Patients with extra weight around the middle who want to understand what it means for heart health
• Patients with a family history of diabetes or heart disease who want numbers checked together
• Patients who want a clear plan for lowering several risks at once instead of one at a time

What to expect

• Measurements of blood pressure and waist size, with your height and weight
• Blood tests for blood sugar, cholesterol, and triglycerides, as your provider orders them
• A talk about food, activity, sleep, smoking, and medicines you already take
• A written plan with a follow-up schedule so you can see whether the numbers move

Why it is not one disease

MedlinePlus says providers are not sure a single cause explains metabolic syndrome. Many of the risks relate to obesity, and people were often first told they had prediabetes, early high blood pressure, or mildly raised blood fats. Any of those three can be the first sign. The most important drivers it names are extra weight around the middle and insulin resistance, where cells respond poorly to insulin and blood sugar rises.

The five measurements

MedlinePlus says the diagnosis is made when you have three or more of these:

• Blood pressure of 130/85 or higher, or taking medicine for high blood pressure
• Fasting blood sugar of 100 to 125 mg/dL, or being treated for type 2 diabetes
• A large waist, from 40 inches for men and 35 inches for women, with lower cut-offs for people of Asian ancestry
• Low HDL cholesterol, under 40 mg/dL in men and 50 mg/dL in women, or taking medicine for it
• Fasting triglycerides above 150 mg/dL, or taking medicine to lower them

How the numbers get checked

A provider examines you and asks about your overall health, and blood tests check sugar, cholesterol, and triglycerides. Preparing for those draws is covered in the fasting blood work preparation guide, and reading the results is covered in the lipid panel guide and the blood pressure readings guide.

What the goals look like

MedlinePlus says treatment aims to reduce the risk of heart disease, stroke, and diabetes. It suggests losing 7 to 10 percent of current weight, with a calorie cut of roughly 500 to 1,000 a day, and notes no single diet works best. It recommends 150 minutes a week of moderate activity such as walking, plus muscle-strengthening on two days, after checking with a provider that it is safe to begin.

Pressure, cholesterol and smoking

MedlinePlus adds eating less salt, losing weight, and exercising to bring blood pressure down, with medicine if needed, and healthier food, weight loss, and activity to lower cholesterol. A provider may suggest daily low-dose aspirin in some cases. If you smoke, it calls now the time to quit and says medicines and programs can help. Care for each piece is listed on the hypertension management and high cholesterol management pages.

Where it can lead

MedlinePlus says people with metabolic syndrome have a higher long-term risk of heart disease, type 2 diabetes, stroke, kidney disease, and poor blood supply to the legs. It also notes some people have other linked findings, such as a higher tendency to clot, signs of inflammation in the blood, and small amounts of albumin in the urine. The related heart disease risk guide covers the cardiovascular side.

Sources

• MedlinePlus — Metabolic syndrome
• MedlinePlus — Metabolic Syndrome health topic