Metabolic Syndrome

Metabolic syndrome is a set of symptoms that occur in persons with increased risk of cardiovascular disease and type 2 diabetes. The syndrome is defined by the occurrence of at least 3 of the 5 findings:

  • The concentration of HDL cholesterol (good cholesterol) is lower than 22.5 mg/dl in men or less than 18 mg/dl in women.
  • The concentration of fats (triglycerides) in blood is higher than 30.5 mg/dl.
  • The level of fasting blood glucose is above 108mg/dl.
  • Blood pressure is higher than 130/85.
  • The waist circumference is over 34.5 (88 cm) in women / over 40.1 inches (106 cm) in men. 

Translated into ordinary language, the typical person affected by the metabolic syndrome suffers from abdominal obesity, high blood fat level and low blood value of "good" HDL cholesterol. These people have usually high blood pressure. Higher blood sugar is usually associated with insulin resistance, when the tissues are unable to process the glucose.


The exact mechanism of the syndrome development has not yet been explored, but the underlying factors are known. It is evident that there are certain genetic conditions that increase the risk of developing the syndrome. Other factors include age and especially unhealthy lifestyle (unhealthy diet with high intakes of energy, fats and sugars and lack of physical activity), leading to weight gain.


Increasing level of sugar in the patient leads to gradual emergence of type 2 diabetes. High blood pressure, type 2 diabetes and high levels of blood triglycerides greatly accelerate the process of atherosclerosis. All these factors lead to damage and narrowing to both large and small arteries, damaging virtually all organs. Most common complications include chronic renal failure, retinal damage (diabetic retinopathy) and subsequent visual disturbances, coronary artery disease (including angina pectoris and myocardial infarction) and peripheral artery disease.


The diagnosis of the syndrome must be confirmed by a doctor, preferably an internal physician. The diagnostic process should include medical history, physical examination (including measuring of blood pressure) and blood samples.


The treatment must begin as soon as possible and it must be comprehensive. It requires plenty of exercise and a healthy diet, which should lead to weight loss. Even weight loss of 10% results in a significant improvement in prognosis. High cholesterol and triglycerides can be treated by hypolipidemic drugs, hypertension is treated by antihypertensives. ACE-Inhibitors are favored in metabolic syndrome, because they not only lower the blood pressure, but they also protect the heart muscle and kidney tissue.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources