Metabolic Syndrome
Metabolic syndrome is a group of disorders that result
from insulin resistance. These disorders are described
below, beginning with insulin resistance.

This is resistance to a natural chemical known as insulin
by cells in the body that are outside the brain and spine.
Insulin's main job is to quickly absorb glucose (a type of
sugar) from the blood into cells for their energy needs
and into the fat and liver (a large organ that performs
many chemical tasks) cells for storage.
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If the cells in the body are resistant to insulin, the insulin level gets too high. Although the
insulin levels are too high, since the cells in the body are resistant to it, it cannot
effectively do its job in absorbing glucose for the body's energy needs. As a result, the
glucose levels get too high as well. Because of this problem, other sources in the body
besides glucose need to be used for energy. Using these additional sources for energy
can lead to the buildup of toxic substances in the body.

About 10-25% of adults have insulin resistance. Insulin resistance increases the level of
salt in the body, which causes blood pressure to increase. Up to 50% of people with
people with high blood pressure have insulin resistance. If insulin resistance gets severe
enough, it can lead to Type II diabetes mellitus.

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TYPE II DIABETES MELLITUS: Diabetes melliutus is a complex,
long-term disorder in which the body is not able to effectively use
insulin. In Type II diabetes, insulin is produced, but the cells in the
body (particularly those outside the brain and spine) resist its
effects, especially when the person is overweight. Although insulin
is produced in Type II diabetes, typically not enough of it is made.
The presence of diabetes mellitus puts one at a higher risk for heart

increase in the amount of fat cells in the body compared to the
amount of other types of cells.
A cell is the smallest, most basic unit of life, that is capable of existing by itself. The obesity in people with
metabolic syndrome is typically in the upper body or belly area. People who are 35 to 40% over their ideal
body weight generally have up to a 40% decrease in insulin sensitivity. Up to 50% of people with people
with high blood pressure have insulin resistance.

HYPERINSULINEMIA: Too much insulin in the body. See above for a description of insulin. In the case of
metabolic syndrome, there is too much insulin in the body because the pancreas (a long organ in the back
of the belly) produces more of it when the body resists its effects. The increased insulin is what leads
many of the other abnormalities that are present in this condition. For example, too much insulin prevents
fat cells from giving up their energy stores to let us lose weight.

BLOOD CLOTTING ABNORMALITIES: Blot clotting is when blood fluid comes together as a solid. This is
caused by abnormalities in the blood.

INCREASED CATECHOLAMINE LEVELS: Catecholamines are types of chemical substances that are
released in the body in response to stress. An example of a type of catecholamine is adrenaline.

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.


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


The people who are most at risk for metabolic syndrome are those who lead inactive lives and who go on
to become obese (very overweight). 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

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

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.


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.


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.


Metabolic syndrome is more common in men.


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.


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.


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.


Yes. Metabolic syndrome can most often be prevented with exercise, a proper diet, and weight loss.


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.


Metabolic syndrome is also known as insulin resistance syndrome, metabolic syndrome X, syndrome X,
the Pluri-Metabolic syndrome, and the Deadly Quartet.


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."