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August 28, 2015

Metabolic Syndrome

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.

As Digestive Health Care specialists, we see people with metabolic syndrome because fatty liver (NAFLD, NASH) conditions are extremely common in those with metabolic syndrome, and the liver blood test change from fatty liver may be the test that brings the metabolic syndrome to attention.

Causes

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 sugars like glucose and other nutrients. Insulin is a hormone made by your pancreas that helps glucose 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.

Risk Factors

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

Signs & Symptoms

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.

Screenings & Diagnostic Tests

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 millimeters 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.

Treatment

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

Treatment Outlook

Long term prognosis for an individual who has metabolic syndrome is good, if the syndrome is treated. Because metabolic syndrome is a cluster of conditions that occur together, by making aggressive lifestyle changes and working with one’s physician, heart disease, stroke and diabetes is preventable.

Lifestyle and Home Remedies

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. Either diet approach reduces the amounts of carbohydrates substantially, and many believe that carbs, particularly the fructose found in many prepared foods, colas etc is the primary culprit for the extent of obesity and metabolic syndrome in our populations.
  • Stop smoking. Smoking cigarettes worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help kicking the cigarette habit.

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