Metabolic syndrome: Symptoms, Causes, Risk factors, Complications, Diagnosis, Treatment and Prevention

Metabolic syndrome is a cluster of conditions that appears together in an individual.

June 21, 2018

Metabolic syndrome is a cluster of conditions that appears together in an individual. These metabolic factors include insulin resistance, high blood sugar, hypertension (high blood pressure), cholesterol abnormalities, excess body fat around the waist that has an increased risk for blood clotting, heart disease, stroke and diabetes. Affected individuals are most often overweight or obese.
It is also known as syndrome X, insulin resistance syndrome, or dysmetabolic syndrome. Metabolic syndrome occurs when a person has three or more of the following measurements:

  • Abdominal obesity (Waist circumference of greater than 40 inches in men, and greater than 35 inches in women)
  • Triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or greater
  • HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Systolic blood pressure of 130 millimeters of mercury (mm Hg) or greater, or diastolic blood pressure of 85 mm Hg or greater
  • Fasting glucose of 100 mg/dL or greater

Symptoms of Metabolic syndrome:

Metabolic syndrome is a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. Even if they are only moderately raised, these risk factors can lead to many complications.
Most of the metabolic risk factors have no signs or symptoms, although a large waist circumference is a visible sign.
You will have signs and symptoms of diabetes if your blood sugar is very high, especially type 2 diabetes that include increased thirst and urination, fatigue, and blurred vision.
Usually high blood pressure has no signs or symptoms. However, some people in the early stages of high blood pressure may have dull headaches, dizzy spells, or more nosebleeds than usual.

Causes of Metabolic syndrome:

With many medical conditions, genetics and the environment both play important roles in the development of the metabolic syndrome. Each individual component of the syndrome, and the syndrome itself is influenced by genetic factors. The chance of developing metabolic syndrome is higher if there is a family history of either type 2 diabetes, hypertension, and early heart disease.
Environmental issues such as lack of physical activities, sedentary lifestyle, and progressive weight gain also contribute to the risk of developing metabolic syndrome.
It is also linked to insulin resistance, when the cells are incapable to respond to the action of insulin in promoting the transport of the sugar glucose, from blood into muscles and other tissues. Normally, your digestive system breaks down the foods you eat into sugar (glucose). Insulin is a hormone made by your pancreas that helps sugar enter your cells to be used as fuel. As cells don't respond normally to insulin in people with insulin resistance, glucose can't enter the cells as easily. As a result, glucose levels in your blood rise despite your body produces more insulin to control the glucose.

Risk factors of Metabolic syndrome:

The following factors increase your chances of having metabolic syndrome:

  • Age: Your risk of metabolic syndrome increases with age.
  • Race: In the United States, Mexican-Americans appear to be at the greatest risk of developing metabolic syndrome.
  • Post-menopausal women: Post menopause, women has a higher risk of developing metabolic syndrome.
  • Obesity: Carrying too much weight, especially in your abdomen, increases your risk of metabolic syndrome.
  • Smoking: Smoking can significantly increase the risk of developing metabolic syndrome.
  • Eating an excessively high carbohydrate diet: This can lead to obesity which is linked to metabolic syndrome.
  • Sedentary lifestyle: Being inactive can lead to obesity and many other condition that can increase the risk of developing metabolic syndrome.
  • Diabetes: You are more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.
  • Other diseases: Your risk of metabolic syndrome is higher if you've ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome

Complications of Metabolic syndrome:

Having metabolic syndrome can increase your risk of developing many health conditions. These include:


Excess weight gain can lead to insulin resistance. As a result of this your glucose levels will continue to increase leading to diabetes. Having diabetes itself has many health complications including vision loss, urinary infections, osteoporosis and PCOS.

Cardiovascular disease:

High cholesterol and high blood pressure can contribute to the buildup of plaques in your arteries. These plaques can narrow and harden your arteries, which can lead to a heart attack or stroke.


Fat accumulation in the liver or fatty liver can develop due to metabolic syndrome, resulting in inflammation and the potential for cirrhosis.

Kidney damage:

As there is an association with microalbuminuria, the leaking of protein into the urine because of high sugar levels, kidneys can also be affected and damage to kidney can happen gradually.
Other problems associated with metabolic syndrome include obstructive sleep apnea, polycystic ovary syndrome, increased risk of dementia with aging, and cognitive decline in the elderly.

Diagnosis of Metabolic syndrome:

Metabolic syndrome is diagnosed if you have three or more of the below conditions or are taking medication to control them:

  • Abdominal obesity (Waist circumference of greater than 40 inches in men, and greater than 35 inches in women)
  • Triglyceride level of 150 milligrams per deciliter of blood (mg/dL) or greater
  • HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women
  • Systolic blood pressure of 130 millimeters of mercury (mm Hg) or greater, or diastolic blood pressure of 85 mm Hg or greater
  • Fasting glucose of 100 mg/dL or greater

Treatment of Metabolic syndrome:

The goals of treatment are to treat both the underlying cause of the syndrome and to prevent the development of conditions associated with metabolic syndrome. As a majority of people with metabolic syndrome are overweight and live a sedentary lifestyle, lifestyle modification is the best way for treatment of metabolic syndrome. Diet, exercise and smoking cessation plays an important role in treatment plan.
If these measures aren't enough, your doctor might suggest medications to help control your blood pressure, cholesterol levels and blood glucose. Lifestyle changes are usually required to prevent serious health problems, such as diabetes and heart disease. These include:

Being physically active:

30 to 45 minutes of moderate-intensity exercise, such as brisk walking, five days a week is recommended to keep you healthy. Look for ways to increase activity, such as walking instead of driving and using stairs instead of elevators when possible.
It can reduce blood pressure, cholesterol levels, and insulin sensitivity, regardless of whether weight loss is achieved or not.

Losing weight.

Weight loss and maintaining a healthy weight can reduce insulin resistance and blood pressure and decrease your risk of diabetes.

Eating healthfully:

The Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, have been found to be effective in weight loss for people who have components of metabolic syndrome. These dietary approach include limiting unhealthy fats and emphasize fruits, vegetables, fish and whole grains. A Mediterranean diet is one that is rich in good fats and contains a reasonable amount of carbohydrates and proteins such as from fish and chicken. It is palatable and easily sustained. In addition, when compared to a low fat diet, people on the Mediterranean diet have a greater decrease in body weight, and also had greater control in blood pressure, cholesterol levels, and other markers of heart disease.
All of these are important in evaluating and treating metabolic syndrome. 

Quit smoking:

Smoking cigarettes worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help quitting.

Managing stress:

Physical activity, meditation, yoga and other programs can help you handle stress and improve your emotional and physical health.

Cosmetic surgery to remove fat:

Liposuction of the abdomen, that is removing the large amount of abdominal fat has shown no benefit on insulin sensitivity, blood pressure, or cholesterol. Diet and exercise are still the preferred primary treatment of metabolic syndrome.


Medications are considered to control cholesterol levels, lipids, and high blood pressure when lifestyle changes does not work. If someone has already had a heart attack, he should take utmost care as he is at greater risk of getting it again because of low LDL.
A person with diabetes has a heart attack risk equivalent to that of someone who has already one and so should be treated in the same way. As each individual is unique and respond to medication differently, you should discuss your lipid profile with your doctor.
A person with metabolic syndrome should maintain his/her blood pressure lower than 130/80. To achieve this goal some medications can be used that helps lowering blood pressure. A class of blood pressure drugs called ACE inhibitors has been found to also reduce the levels of insulin resistance and reduce the risk of developing type 2 diabetes along with reducing blood pressure. Therefore, it is an important consideration when discussing the choice blood pressure drugs in the metabolic syndrome.
Also medications that are used to treat high blood sugar and insulin resistance may have beneficial effects on blood pressure and cholesterol profiles. Metformin (Glucophage), usually used to treat type 2 diabetes, can also be used in treating PCOS which can help prevent the onset of diabetes in people with metabolic syndrome.

Prevention of Metabolic syndrome:

Preventing metabolic syndrome really means having a healthy lifestyle. Choosing healthier lifestyles such as exercising, losing weight, lowering blood pressure, cholesterol and triglyceride levels may decrease the chance of developing metabolic syndrome. Here are few tips for a healthy lifestyle:

Choose a Healthy and Balanced Diet:

Eat regularly small meals with intervals and include starchy carbohydrates as well as plenty of fruit and vegetables. Decrease consumption of fats. You can reduce the amount of fat, salt and sugar in your diet, and increasing the amount of fiber.
You can and enjoy a wide range of foods and have a varied diet as long as you eat regularly and make healthy choices.If your diet is well balanced, you should be able to achieve a good level of health and maintain a healthy weight.

Regular Exercise:

Regular exercise will help you keep away from all kind of health issues. Aerobic activity, such as cycling or fast walking can be included as a part of your physical activity for 30 to 45 minutes per day.

Give up Smoking:

Smoking increases your risk of developing a cardiovascular disease, such as a heart attack or stroke and many other serious smoking-related conditions, such as lung cancer. Your GP can provide you with advice, support and treatment to help you quit smoking.