In this discussion from an issue of the Johns Hopkins Heart Bulletin, Simeon Margolis, M.D., Ph.D. answers readers' questions about metabolic syndrome.
Q. Is metabolic syndrome a disease or medical condition?
Dr. Margolis answers: Metabolic syndrome is neither a disease or disorder but rather a term used to describe a cluster of specific disorders that, when they occur together, may significantly increase a person's risk of developing cardiovascular disease or type 2 diabetes. The value of the term is that it alerts both patient and physician that heart disease and diabetes, two seemingly disparate ailments, actually share common triggers.
You shouldn't look at metabolic syndrome as a disease per se, but as a group of important warning signs that something is medically wrong and needs to be fixed.
Q. What conditions constitute metabolic syndrome?
Dr. Margolis answers: Metabolic syndrome has no symptoms but the abnormalities involved can be detected by a physician. The actual definition of metabolic syndrome is under debate among medical groups and has pitted cardiac experts against endocrinologists in heated discussions over the validity of metabolic syndrome as a diagnosis.
By the definition determined by the National Cholesterol Education Program of the National Heart, Lung, and Blood Institute (this is only one of several definitions of metabolic syndrome), you have metabolic syndrome if you have at least three of the following five abnormalities:
- Abdominal obesity (a waist circumference greater than 40 inches in men or 35 inches in women) indicates central obesity and an "apple shape," which is a major risk factor for metabolic syndrome.
- A low HDL (good) cholesterol level (less than 40 mg/dL in men or less than 50 mg/dL in women).
- A high fasting triglyceride level (150 mg/dL or higher) indicates hypertriglyceridemia, high blood levels of triglycerides, the most abundant fat in the body.
- Higher-than-normal blood pressure (130/85 mm Hg or higher) or taking a blood pressure-lowering medication.
- Elevated fasting blood glucose level (110 mg/dL or higher). Your glucose, or blood sugar, levels are elevated following a fast but are not high enough to constitute diabetes. Elevated glucose levels signify insulin resistance, the inability of the body to utilize glucose efficiently.
