What is ?Statistics on Risk Factors for Progression of Symptoms of Clinical Examination of How is Diagnosed?Prognosis of How is Treated? ReferencesWhat is ?
is diagnosed when a number of metabolic abnormalities (including insulin resistance and obesity) occur at the same time in an individual. Individuals who have the syndrome are more likely to develop cardiovascular disease and type 2 diabetes mellitus than those who do not. is defined by the International Diabetes Federation as:
Central obesity, indicated by a waist circumference (ethnicity specific)Plus any two of the following: Increased triglyceridesIncreased high density cholesterolHigh blood pressureHigh fasting plasma glucoseStatistics onis an alarmingly common health condition, occurring in some 20–25% of the world's population. In Australia, it is estimated that one in three people over the age of 25 years have the .
Risk Factors for
Individuals who have a higher risk of developing include:
Obese individuals, particularly those with obesity around their abdomen;Individuals consuming large amount of saturated fats;Individuals who consume more than one (in women) or two (in men) standard drinks of alcohol per day, or more than four (in women) or six (in men) standard drinks in a single session (commonly known as binge drinking) at least once a week;Individuals with schizophrenia are 2–4 times more likely to develop than non-schizophrenic individuals;Insulin resistant individuals;Individuals with a family history of insulin resistance and/or type 2 diabetes.Progression of
Unhealthy eating habits and lack of physical activity are the key lifestyle factors leading to . Extended periods of unhealthy eating and limited physical activity result in obesity and insulin resistance, which in turn affect the body's metabolism and increase the risk of . Once is diagnosed, the syndrome is likely to worsen. If left untreated, individuals may go on to develop additional metabolic abnormalities. In addition, once is diagnosed, other metabolic abnormalities (e.g. abnormal blood pressure response to changes in dietary salt) also tend to worsen.
Individuals diagnosed with are up to three times more likely to develop cardiovascular health problems, and up to five times more likely to develop type 2 diabetes, than individuals who do not have .
Clinical Examination ofIf a doctor suspects a patient to have , they will likely measure the patient's waist to assess central obesity (alternatively, a body mass index > 30 also indicates obesity). If central obesity is diagnosed, further investigations may be undertaken to assess blood pressure and glucose, triglyceride and cholesterol levels.
Body Mass Index (BMI) Calculator Enter your height and weight below to find out your BMI. Weight (kg): Height (m): Body Mass Index: What does this mean?
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Patients are diagnosed with if their waist circumference measure shows that they are centrally obese and their test results show at least two metabolic abnormalities.
Prognosis ofWhile many individuals with go on to develop type 2 diabetes and CVD, the condition can be resolved through diet and lifestyle changes. Early intervention increases the chances of successful treatment. Individuals with may also develop conditions associated with diabetes, even if they do not receive a diabetes diagnosis. For example individuals with may develop diabetic retinopathy.
How is Treated?The treatment of generally focuses on diet and exercise therapy. To reverse the metabolic abnormalities of , regular physical activity and a diet with a restricted calorie intake, that is high in whole grains, monounsaturated fats and plant foods (such as the Mediterranean diet), are recommended.
Virtual Medical Centre Video
Click here to watch a video on diet and the . If diet and exercise interventions fail to regulate metabolic abnormalities, doctors may provide medications to reduce blood pressure or cholesterol levels. A comprehensive approach to the management of , including diet, exercise and medication for metabolic abnormalities, is known as the ABCDE approach. This stands for:
A: Assessment of cardiovascular risk and aspirin therapyB: Blood pressure controlC: Cholesterol managementD: Diabetes prevention and diet therapyE: Exercise therapy
Overview of medical treatment of
There are currently no medications available that treat all the metabolic abnormalities of together. If a doctor prescribes medications to treat , they will prescribe specific medications to treat each abnormality separately.
Aspirin therapy is the most common treatment to reduce the risk of cardiovascular diseases, while angiotension-converting enzyme (ACE) inhibitors and angiotension receptor blockers (ARBs) are likely to be prescribed for patients requiring blood pressure control. Fibrates and statins are recommended for cholesterol control.
Assessment of cardiovascular risk and aspirin therapy
The doctor will assess the risk of cardiovascular disease, by using the Framingham risk score. When the Framingham risk score indicates a risk of cardiovascular disease greater than 5%, the doctor will probably recommend daily doses of aspirin to correct the problem. While aspirin does not require a prescription and is commonly used for dealing with fevers and headaches, individuals should always consult a doctor before taking aspirin on a daily basis. This is because daily consumption of aspirin can result in dangerous bleeding in some individuals.
Blood pressure control
Medications for blood pressure control may be prescribed for patients with and a blood pressure higher than 130/80 mmHg. The most commonly prescribed medications are ACE inhibitors and ARBs.
Cholesterol management
There are two types of cholesterol in the body: low density lipoprotein cholesterol (LDL-C or bad cholesterol); and high density lipoprotein cholesterol (HDL-C or good cholesterol). The goal of cholesterol management is to reduce levels of LDL-C and increase levels of HDL-C.
Diabetes prevention and diet therapy
Losing weight by eating less high fat foods is very important for individuals who have . It can reduce the risk of developing type 2 diabetes and may also reduce the risk of coronary heart disease.
For individuals with , reducing total calorie intake is important. However, eating the correct combination of foods is also very important.
Calorie CounterCalculate your daily calorie intake and compare it to your recommended daily intake.
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Dietary modifications
Diets low in saturated fats (e.g. fat derived from animals), red meat and sugar, but high in monounsaturated fats (e.g. olive oil), fresh fruits, vegetables and whole grains, provide the greatest health benefit for individuals with (and individuals who wish to prevent ). This nutritional combination is typical of a Mediterannean diet.
Exercise therapy
Increased physical activity increases weight loss and decreases the risk of diabetes and coronary heart disease. Exercise is therefore a very important component of any treatment for treatment.
At least 30 minutes of moderate intensity exercise per day is recommended for general health. Walking is a particularly good form of exercise and individuals with should try to walk more (e.g. to work or the shops, with friends or children).
More information
For more information on fitness and exercise, including stretches, types of exercise, exercise recovery and exercise with health conditions, as well as some useful videos, see Fitness.
For more information on nutrition, including information on types and composition of food, nutrition and people, conditions related to nutrition, and diets and recipes, as well as some useful videos and tools, see Nutrition. 
For more information on obesity, health and social issues, and methods of weight loss, as well as some useful tools, see Weight Loss. ReferencesInternational Diabetes Federation. The IDF consensus worldwide definition of the [online]. 4 September 2006 [cited 26 September 2008]. Available from: URL linkWorld Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation, Part 1: Diagnosis and classification of diabetes mellitus, Geneva, 59p, WHO/NCD/NCS/99.2 [online]. 1999 [cited 26 September 2008]. Available from: URL linkExpert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97. [Abstract]Alberti KG, Zimmet P, Shaw J. The : A new worldwide definition. Lancet. 2005;366:1059-62. [Abstract]Dunstan W, Zimmet P, Welborn T, Cameron AJ, Shaw J, et al. The Australian Diabetes, Obesity and Lifestyle Study (AusDiab): Methods and response rates. Diab Res Clin Prac. 2002;57(2):119-29. [Abstract]Esposito K, Ceriello A. Giugliano D. Diet and the . Metab Syndr Relat Disord. 2007;5(4):291-6. [Abstract]Fan AZ, Russell M, Naimi T, Li Y, Liao Y, et al. Patterns of alcohol consumption and the . J Clin Endocrinol Metab. 2008;93(10):3833-8. [Abstract | Full text]Saari KM, Lindeman SM, Viilo KM, Isohanni MK, Järvelin MR, et al. A 4 fold risk of in patients with schizophrenia: The Northern Finland 1966 Birth Cohort Study. J Clin Psychiatry. 2005;66(5):559-63. [Abstract]Blaha M, Elasy TA. Clinical use of : Why the confusion? Clin Diab. 2006;24(3):125-31. [Abstract | Full text]Blaha MJ, Bansal S, Rouf R, Golden SH, Blumenthal RS, Defilippis AP. A practical "ABCDE" approach to the . Mayo Clin Proc. 2008;83(8):932-41. [Abstract | Full text]Correia ML. and blood pressure: The salty connection. J Hum Hypertens. 2007;21(6):427-30. [Abstract]Heiskanen T, Niskanen L, Lyytikäinen R, Saarinen PI, Hintikka J. in patients with schizophrenia. J Clin Psychiatry. 2003;64(5):575-9. [Abstract]Redline S, Storfer-Isser A, Rosen CL, Johnson NL, Kirchner HL, et al. Association between and sleep-disordered breathing in adolescents. Am J Respir Crit Care Med. 2007;176(4):401-8. [Abstract | Full text]Wu G, Management of proliferative diabetic retinopathy. Chap 9. Diabetic Retinopathy- The Essentials. 2010. pp122-137. [cited 2011, Mar 10] [Book]
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