What is it?

Metabolic syndrome is a set of risk factors that includes: abdominal obesity, a decreased ability to process glucose (insulin resistance), dyslipidemia (unhealthy lipid levels), and hypertension. Patients who have this syndrome have been shown to be at an increased risk of developing cardiovascular disease and/or type 2 diabetes. Metabolic syndrome is a common condition that goes by many names (dysmetabolic syndrome, syndrome X, insulin resistance syndrome, obesity syndrome, and Reaven's syndrome), but few outside the medical community have heard of it. Most patients have been educated about the importance of checking their cholesterol levels, watching for signs of diabetes, having their blood pressure monitored, and exercising – but there has been little to tie all of these factors together except pursuit of a "healthier lifestyle."

The World Health Organization (WHO) was the first to publish an internationally accepted definition for metabolic syndrome in 1998, but the criteria that have received the most widespread acceptance and use are those proposed as part of ATP III (the third report of the National Cholesterol Education Program expert panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults). ATP III defines metabolic syndrome as involving three or more of the following:

Central/abdominal obesity as measured by waist circumference [Men - Greater than 40 inches (102 cm); Women - Greater than 35 inches (88 cm)] Fasting triglycerides greater than or equal to 150 mg/dL (1.69 mmol/L) HDL cholesterol [Men - Less than 40 mg/dL (1.04 mmol/L); Women - Less than 50 mg/ dL (1.29 mmol/L)] Blood pressure greater than or equal to 130/85 mm Hg Fasting glucose greater than or equal to 110 mg/dL (6.1 mmol/L)

Also frequently seen with metabolic syndrome but not included with the ATP III criteria are prothrombotic (blood clotting) and proinflammatory tendencies. While these combined criteria and risk factors do not usually cause overt symptoms, they are a warning of an increased likelihood of clogged arteries, heart disease, stroke, diabetes, kidney disease, and even premature death. If left untreated, complications from untreated metabolic syndrome can develop in as few as 15 years. Those patients who have metabolic syndrome and also smoke tend to have an even poorer prognosis.