What is Syndrome X or Metabolic Syndrome?
Syndrome X, or metabolic syndrome, describes a set of health conditions that often occur together. These include excessive fat around the abdomen, disorders of blood fats that lead to the buildup of plaque in the arteries, insulin resistance, and high blood pressure. All these components of the metabolic syndrome put you at risk of developing heart disease and type 2 diabetes.
Do you have syndrome X?
According to the National Cholesterol Education Panel, if you have at least three of the following characteristics, you have metabolic syndrome:
- Fasting blood glucose of 110 mg/dl or higher
- Abdominal obesity –a waist size greater than 40 inches for men, and 35 for women.
- Triglyceride levels of 150 mg/dl or higher
- HDL –the “good” cholesterol of less than 40 mg/dl in men and 50 md/dl in women
- Blood pressure of 130/85 mm Hg or higher
Diabetes develops when insulin is not produced in sufficient amounts by the pancreas –a condition called insulin deficiency- or the cells don’t respond to insulin properly –a condition called insulin resistance. In both cases, glucose is unable to enter the cells and it starts piling up in the bloodstream causing high blood sugar.
The two components of syndrome X, insulin resistance and abdominal obesity are the major risk factors for heart trouble. As we have already seen, insulin resistance prevents blood sugar to enter the cells. As a result, the pancreas produces more and more insulin to keep blood glucose normal. Insulin resistance tends to occurs when people gain weight.
Insulin resistance causes damages in the walls of blood vessels which in turn begins the process leading to heart disease. Elevated insulin or hyperinsulinemia is also associated with other risk factors for heart disease such as:
- High triglycerides
- HDL (“good” cholesterol) that is too low
- High LDL (“bad” cholesterol)
- Elevated clotting factors such as a compound called PAI-1 (plasminogen activator Inhibitor-1)
Abdominal fat, or tummy fat, is another component of the metabolic syndrome, and can also affect the metabolism of sugar. Why does this fat cause so much trouble? Several reasons:
- In your abdominal region you have two types of fat: the fat you can squeeze at your waist between your fingers; we call it subcutaneous fat.
- Below the subcutaneous fat we find another type of fat: deep fat. This is the fat that cushions and protects the internal organs. It is called visceral fat or intra-abdominal fat.
Visceral fat is more active than subcutaneous fat in the sense that it releases molecules of fat into the bloodstream. The fat molecules released by the visceral fat go directly to the liver and to the bloodstream. This makes muscle cells inefficient at using your body’s insulin, and as a result insulin resistance develops.
Insulin resistance is associated with high blood pressure, low HDL, and high triglycerides, all the conditions that are part of the metabolic syndrome.
Metabolic Syndrome Work Sheet
As you can imagine, it is very important to know your numbers: your cholesterol levels, blood pressure, blood sugar, and triglyceride levels. Blood tests can determine whether you have high cholesterol or high triglyceride levels, and these are typically part of a routine physical examination. Here is a work sheet you can use to figure your risk for syndrome X, prediabetes, and diabetes.
|Metabolic Syndrome or Syndrome X Work Sheet|
|What to Measure||My Numbers||What My Results Mean|
|My waist circumference||A waist size greater than 40 inches for men and 35 inches for women is a risk factor for metabolic syndrome.|
|Triglycerides||A value above 150 is a risk factor|
|HDL cholesterol||A value of less than 40 in men and less than 50 in women is a risk factor|
|Blood pressure||A reading of 130/85 or greater is a risk factor for metabolic syndrome|
|Fasting blood glucose||If your fasting blood glucose is 100 or above, this is a risk factor|
|Number of risk factors I have||Any of three of five risk factors constitutes the presence of metabolic syndrome|
|Waist circumference is a convenient way of measuring abdominal fat. Use a tape measure to find your waist circumference. To measure your waist accurately, place a tape measure around your bare abdomen just above your hip bone. Be sure the tape does not compress your skin, and is parallel to the floor. Relax, exhale, and measure your waist.|
How is syndrome X treated?
Metabolic syndrome can be easily treated with proper diet and moderate physical activity. The treatment includes:
- Weight control
- Physical activity
- Normalize blood pressure
- Top smoking if you are a smoker.
Metabolic syndrome and pre-diabetes
Prediabetes means having early metabolic abnormalities that precede the development of type 2 diabetes. It includes:
- Having impaired fasting glucose. A fasting glucose ranging between 100 and 125 mg/dl is considered as impaired fasting glucose.
- Impaired glucose tolerance. A two-hour plasma glucose value greater than 140 md/dl, but less than 200 mg/dl, is termed impaired glucose tolerance.
- High than normal blood sugar, although not high enough to be called diabetes.
With prediabetes, you also have more of a risk for developing heart disease and other associated complications. Approximately 26 percent of U.S. adults have prediabetes or impaired fasting glucose. Add that to the number of people with diabetes, and you will find that seventy-three million Americans have prediabetes or diabetes.
Fortunately, we do know that lifestyle changes are effective in treating prediabetes. For example, if you lose 5 to 7 percent of your body weight which is about 12 to 18 pounds for someone who weighs 250 pounds, by making modest changes in your diet and level of physical activity, you stand a good chance of arresting the progression of prediabetes to diabetes.
Make sure you get the necessary lab tests to check what your numbers are. Plug the numbers in the above work sheet and if you have two or three risk factors talk to your doctor. Ask him/her to refer you to a Registered Dietitian so you can start a nutrition and physical activity plan to reverse the health issues that came up with your blood test. Any of the conditions that are part of the metabolic syndrome are reversible, so don’t wait until it is too late and your doctor diagnoses diabetes.
To your health!
Emilia Klapp, R.D., B.S.