HYPERGLYCERIDEMIA: Too many glycerides (a type of fatty chemical) in the body. Fatty substances increase in the blood in response to increased insulin. For example, increased amounts of insulin cause the liver to make increased amounts of triglycerides (a type of fat). The liver is the largest organ in the body and is responsible for filtering (removing) harmful chemical substances, producing important chemicals for the body, and other important functions. The excess triglycerides build up in the belly area and cause increased weight gain. Excess triglycerides also decrease the ability of the body to produce good cholesterol. Cholesterol is a waxy, fatty substance found only in animal tissues. Good cholesterol helps to eliminate bad cholesterol. See below for more information on good and bad cholesterol.
WHAT ARE SOME MORE DETAILS ON HOW INSULIN WORKS?
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Insulin is normally released from the pancreas when the body detects a rise of glucose in the blood. This usually happens a few minutes after every meal. Insulin normally helps store glucose and amino acids for the energy needs of cells, such as muscle cells. Amino acids are a group of chemical substances that form proteins. When insulin stores glucose in the liver, it changes it to a type of carbohydrate known as glycogen. Carbohydrates are a group of substances present in certain types of foods (such as sugar) that provides the body with energy. Insulin also helps prevent the formation of glucose from substances that are not carbohydrates, such as proteins.
Since insulin helps store glucose, it helps the body tolerate glucose. Glucose tolerance is said to be normal if a rise in glucose causes a release of insulin, which takes glucose into cells. In metabolic syndrome, one problem is that glucose tolerance is impaired to the point that it threatens and impairs health.
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WHO GETS METABOLIC SYNDROME?
The people who are most at risk for metabolic syndrome are those who lead inactive lives and who go on to become obese (very fat). People who have lots of fat in the belly area are especially prone to developing metabolic syndrome. It is also believed that metabolic syndrome runs in families. Minorities, such as African-Americans, Asians, Hispanics, and Native Americans are at risk for developing metabolic syndrome.
People who have a history of Type II diabetes (see above), high levels of fat in the blood, or high blood pressure are at risk for developing metabolic syndrome. People who have parents, brothers, or sisters with diabetes are also at risk for metabolic syndrome. People with a skin condition called acanthosis nigricans are at risk for developing metabolic syndrome. Acanthosis nigricans is a darkened, velvety thickening of the skin. Almost 90% of women with these skin changes have insulin resistance. These skin changes are usually present at the neck and body folds. Both dark skinned and light skinned people can get this skin condition. The condition improves with better diet and weight loss.
People with gestational diabetes are also at risk for developing metabolic syndrome.
Gestational diabetes is a condition in which women develop intolerance to glucose during pregnancy. This intolerance is usually first recognized during the time between the 28th week of pregnancy and birth. After giving birth, the levels of glucose usually become normal again, but may remain impaired or develop into diabetes mellitus (see above).
Women with polycystic ovaries are also prone to getting metabolic syndrome. Polycystic ovary syndrome is a disturbance characterized by too much hair growth, an inability to produce children, anovulation, and amenorrhea. Ovaries are organs in the female body that normally produce eggs. Anovulation is when these eggs are not produced or not released by the ovaries. Amenorrhea is not menstruating, which is a when the female reproductive organ bleeds and releases unneeded tissues.
WHAT SHOULD I BE MOST CONCERNED ABOUT IF I HAVE METABOLIC SYNDROME?
The main concerns are that metabolic syndrome puts people at an extremely high risk for heart disease, blood vessel disease, and premature death (dying too early). However, aggressive treatment can successfully decrease the risk of life-threatening complications from metabolic syndrome.
HOW MANY PEOPLE HAVE METABOLIC SYNDROME?
According to the Centers for Disease Control, it is estimated that approximately one in five people in the United States have metabolic syndrome. One in four people past the age of 60 have it. Overall, that comes to approximately 47 million Americans who have this problem. This information was published in the January 16, 2002 edition of the Journal of the American Medical Association
IS METABOLIC SYNDROME MORE COMMON IN MEN OR WOMEN?
Metabolic syndrome is more common in men.
WHERE IS METABOLIC SYNDROME THE MOST COMMON?
Metabolic syndrome is most common in Western countries, such as the United States, and not as common in Eastern countries such as China or India.
IS METABOLIC SYNDROME A NEW MEDICAL CONDITION?
Metabolic syndrome has been around for thousands of years, however, it never had a name. It was not until 1988 that it was recognized that all of the disorders that make up this condition fits into its own syndrome. A syndrome is a group of signs and symptoms that occur together and have a common cause, representing a certain disease or inherited (passed on from the parents' biological makeup) abnormality. A sign is clear evidence of disease that can be measured or seen (unlike a symptom), such as a fever or a rash. A symptom is an indication of a disease or a change in condition that is reported by the patient but is not observed by others.
HOW IS METABOLIC SYNDROME TREATED?
Treatment of metabolic syndrome involves treating all of the symptoms present in a given person. Luckily, what treats one symptom of metabolic syndrome is usually good at treating the others. As was mentioned earlier, aggressive treatment can successfully decrease the risk of life-threatening complications from metabolic syndrome. Although there are medications that can be used to treat aspects of metabolic syndrome (such as using the medication, Glucophage, to decrease insulin resistance), there is no magic pill that can be taken to make metabolic syndrome go away. See the end of this section for more information on medications for metabolic syndrome.
Since insulin resistance is the cause of the problems in metabolic syndrome, it makes sense that treatment would focus on decreasing insulin resistance. The best treatment for this is a proper diet, exercise, and weight loss. Specifically, people with metabolic syndrome should try to get their weight down to within 20 percent of what their weight should be, based on height and age. Losing 16% of one's body weight improves the body's ability to use glucose by 100%. Exercise should consist of 30 minutes of sustained walking a day.
The diet should be low in calories and low in cholesterol. Cholesterol is a waxy, fatty substance found only in animal tissues. The diet should be high in fruits vegetables, and dietary fiber. Dietary fiber is a term for chemical substances in the cells of plants that cannot be digested by the human body. Dietary fiber adds bulk (mass) to the diet and helps prevent disease of the intestine and the colon. High levels of dietary fiber can be found in oats, peas, beans, prunes, brussels sprouts, cabbage, and sweet potatoes. Dietary fiber slows the increase in blood sugar when you eat so it helps to decrease insulin resistance.
Many doctors advise that diets high in refined carbohydrate should be avoided. Carbohydrates are a group of substances present in certain types of foods (such as sugar) that provides the body with energy. Refined carbohydrates are those in which the nutrients have been removed. Eating a lot of carbohydrates causes the insulin level to rise, which in turn, makes sugar levels rise. Since there is already too much insulin in people with metabolic syndrome, eating too many carbohydrates will just add to the increase in blood sugar levels. Foods with lots of carbohydrates include sugary foods, sodas, breads, pasta, and potatoes. Complex carbohydrates, such as beans, grains, and vegetables are better to eat because the nutrients have not been removed.
Saturated fats should be avoided. Saturated means to be filled up with something. In the case of fats, saturated refers to how much hydrogen (a kind of element) is contained in it. Saturated fats are filled with hydrogen and are the most harmful to eat. Foods with lots of saturated fats are fried foods, cookies, crackers, pastries, movie popcorn, and many types of stick margarines or butters. The amount of saturated fat is located on the food label. Eating white meat chicken (without the skin), fish, lean meats, and nonfat dairy products is good for you.
Eating more monosaturated fats and polyunsaturated fats is a good way to partially treat metabolic syndrome. Monosaturated fat has only one gap in it where there is no hydrogen. Polyunsaturated fat has many gaps in it where there is no hydrogen and comes mainly from plants. Foods with monostaurated and polyunsaturated fats include nuts, avocados, nut butters, seeds, fish, olive oil, and canola oil.
Weight loss and exercise also do a good job of treating the high levels of fatty substances in the blood. One important goal is to reduce the levels of LDL. LDL stands for low-density lipoprotein cholesterol. LDL is called the "bad cholesterol" because it can cause cholesterol to build up, which can lead to blockage of the arteries. Arteries are blood vessels that pump blood away from the heart. When LDL levels are reduced, the goal is to reduce the level of triglycerides (a type of fat) in the blood and to raise the HDL level. HDL stands for high-density lipoprotein cholesterol. HDL is called the "good cholesterol" because it helps prevent cholesterol from building up in your arteries.
Reducing fatty substances and cholesterol in the blood can be achieved with medications as well. These are usually used in people who cannot lower their cholesterol with diet and exercise. Doctors usually prescribe medications known as statins (such as Lipitor) to lower cholesterol. Statins block an enzyme the body needs to make cholesterol. An enzyme is a type of protein that helps produce chemical reactions in the body. Other medications are also used to reduce cholesterol and fat in the blood. Medications such as Glucophage, Rezulin, and Precose can improve the body's sensitivity to insulin by decreasing the amount of glucose in the blood. If you have metabolic syndrome, ask your doctor which medication is right for you.
People with metabolic syndrome also need to stop smoking. Smoking makes insulin resistance worse and it decreases the levels of good cholesterol in the blood. It also increases high blood pressure and the amount of fatty substances in the blood. Too much alcohol use can also have the same effect as smoking. However, moderate alcohol use (no more than a drink a day for women) can decrease insulin resistance and the amount of fatty substances in the blood.
To help prevent blood clots from forming, patients with metabolic syndrome are often given aspirin because aspirin thins the blood. For those who have high blood pressure, diet, exercise, weight loss, and medication management can be useful forms of treatment as well.
CAN METABOLIC SYNDROME BE PREVENTED?
Yes. Metabolic syndrome can most often be prevented with exercise, a proper diet, and weight loss.
WHO DISCOVERED METABOLIC SYNDROME?
It was not until 1988 that Dr. Gerald Reaven, a professor of medicine at Stanford University School of Medicine , first used the term "syndrome x" to describe the disorders present in this condition.
WHAT ELSE IS METABOLIC SYNDROME KNOWN AS?
Metabolic syndrome is also known as insulin resistance syndrome, metabolic syndrome X, syndrome X, the Pluri-Metabolic syndrome, and the Deadly Quartet.
WHAT IS THE ORIGIN OF THE TERM, METABOLIC SYNDROME?
Metabolic comes from the Greek word "metabole" meaning "change," and the Greek work "ikos" meaning "pertaining to." Syndrome comes from the Greek word "syn" meaning "together," and the Greek word "dromos" meaning "course." Put the words together and you get "pertaining to change course together."
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