G’day team,
Okay so a bit of a confession here, I may have gone a little sensationalist on the headline when I said it’s killing us all. None the less, Metabolic Syndrome is an extremely important condition that we’re just beginning to get a full picture of, and it's increasing prevelence is becoming an issue worldwide!
We’ve all heard of the obesity epidemic, the diabetes epidemic and the heart disease epidemic. But who’s heard of Metabolic Syndrome? While knowledge heart disease and diabetes have existed for millennia, the recognition of metabolic syndrome is a relatively recent occurrence in medicine. This rather confusing syndrome can be thought of as the grandparent and grandchild of the diseases above. Both a consequence and a cause of each.
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Metabolic syndrome is best explained as a comprehensive risk analysis, a sort of overall marker for unhealthy individuals. It looks at indicators of poor health in a number of areas related to obesity, heart disease and diabetes, in order to draw ….?
So what factors do we look at when considering metabolic syndrome… well here are the ‘diagnostic criteria’ from the National Heart, Lungs and Blood Institute.
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A diagnosis of Metabolic Syndrome requires 3 of the 5 following criteria
- Fasting glucose ≥100 mg/dL (or receiving drug therapy for hyperglycemia)
- Blood pressure ≥130/85 mm Hg (or receiving drug therapy for hypertension)
- Triglycerides ≥150 mg/dL (or receiving drug therapy for hypertriglyceridemia)
- HDL-C <40 mg/dL in men or <50 mg/dL in women (or if medicated for reduced HDL-C)
- Waist circumference ≥102 cm (40 in) in men or ≥88 cm (35 in) in women; if Asian American, ≥90 cm (35 in) in men or ≥80 cm (32 in) in women
Breakdown
Fasting Blood Glucose
An elevated fasting blood glucose indicates insulin resistance. This is the underlying problem that leads to diabetes, and in turn is generally caused by damage due to fluctuating blood glucose levels, from things like a bad diet.
Blood Pressure
Now everyone knows that high blood pressure is bad, but what’s it caused by and why’s it so terrible? While it’s a complex and multifactorial condition, elevated blood pressure (known in the medical field as hypertension) is generally caused by hardening of the blood vessels (a complex process known as atherosclerosis).
When our blood vessels are exposed to elevated levels of cholesterol, fats, and blood glucose they are prone to becoming inflamed and damaged. Over time this constant insult leads to hardening of our vessels.
Hard vessels don’t allow blood to flow well and resist the beating of the heart. In order to compensate and keep our blood flowing, the heart beats harder, raising our blood pressure but suffering from unhealthy strain and stress in the process.
Triglycerides
Triglycerides are basically a fancy medical term for fats. More fat in the blood… well, that’s just bad. As mentioned above high blood fats can lead to atherosclerosis, contributing to hypertension.
High blood triglycerides are also a marker of obesity, another factor that we’ll be considering on this list.
HDL-C
Now let’s break this one down a little.
HDL stands for High Density Lipoprotein and HDL-C is a test used to gain a relatively accurate measurement of HDL levels in the blood.
When fats are absorbed in the gut they’re moved around in the blood in lipoproteins. A lipoprotein with lots of fat in it is generally carrying this fat to our adipose (fat) cells, these are known as Low Density Lipoproteins or LDL's.
A lipoprotein responsible for bringing excess fat from the body to the liver, where it’s eliminated, has a lot more protein than fat and is known as a High Density Lipoprotein (HDL). So it’s easy to tell why a lack of HDLs is in indicator for poor health.
Waist Circumference
Now this won’t come as a surprise to anyone, but obesity is an indicator of ill-health. What may come as a surprise is that it does make a difference *where we are fat.
Adipose tissue around our waist, especially that inside our abdominal cavity (known as visceral fat), is the worst kind. It indicates that we’re prone to story fat around our organs and a liver, heart or kidney wrapped in fat is bad news.
Bringing it Together
As you can see, each of the factors that contributes to Metabolic Syndrome is also a major contributor to poor heart health, obesity and hypertension. Each of these conditions, in turn, increases the risk of the others as well.
The take-home message about Metabolic Syndrome is that as we push our body into ill-health in one area, we also put strain on others.
As we consume fatty foot we provide body with calories to become obese, blood glucose to promote atherosclerosis and insulin resistance.
Who gets it?
There are a number of risk factors for metabolic syndrome, none of them surprising
- Obesity
- Menopause
- Age (older is worse)
- Smoking
- A diet high in carbohydrates
- A lack of physical activity
- Family history of diabetes or metabolic syndrome
Management
So how do we help people with Metabolic Syndrome? The first, and most useful, thing that needs to be done is a change in lifestyle. Smoking cessation, changes in diet and an increase in physical activity are all vital components to controlling or reversing the condition.
Thanks
-tfc
Disclaimer
Now it’s important to understand that the overview above is just the basics. There are obviously even more factors that contribute to each of the processes I’ve mentioned above, but unless you want a full two months of medical education crammed into a single post, we’re going to have to leave it here.
Resources
National Institute of Health
Heart Foundation
World Health Organisation
Up-to-date
The metabolic syndrome: a glance at its history.
CBS News
Cholesterol, Lipoproteins and the Liver
Medscape
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