What is Metabolic Syndrome – Syndrome X

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Metabolic syndrome is also known as insulin resistance syndrome and syndrome X. People who have this syndrome are typically overweight, have slowed metabolisms that cause their bodies to store fat and are reluctant to exercise.

One in every five overweight individuals you meet on the street has this syndrome. This syndrome can lead to other serious disorders such as cardiovascular disease, kidney disease, and hardening of the arteries.

Metabolic syndrome is a cluster of at least three of the five medical conditions listed below:

  • abdominal obesity
  • high blood pressure
  • high blood sugar
  • high serum triglycerides
  • low serum high-density lipoprotein (HDL)

About 25% of the adult population in the United States has metabolic syndrome, a proportion that increases with age, especially among racial and ethnic minorities. Insulin resistance, metabolic syndrome, and prediabetes are intertwined and have overlapping characteristics.

It is believed that an underlying disorder of energy utilization and storage causes the syndrome. The etiology of the syndrome is a topic of active medical investigation.

Symptoms of Metabolic Syndrome

Central obesity, also known as visceral, male-pattern, or apple-shaped adiposity, is the defining characteristic of metabolic syndrome. It is characterized by the accumulation of adipose tissue primarily around the abdomen and trunk.

Other signs of metabolic syndrome include impaired fasting glucose, high blood pressure, decreased fasting serum HDL cholesterol, elevated fasting serum triglyceride level, insulin resistance, or prediabetes.

The World Health Organization has the following criteria for metabolic syndrome:

  • Blood pressure greater or equal to 140/90
  • Dyslipidaemia: which is triglycerides (TG) greater than or equal to 1.695 mmol/L and high-density lipoprotein cholesterol (HDL-C) less than or equal to 0.9 mmol/L (male), less than or equal to 1.0 mmol/L (female), a waist: hip ratio greater than 0.90 (male); greater than 0.85 (female), and/or a body mass index greater than 30 kg/m2 and a microalbuminuria: urinary albumin excretion ratio of greater than or equal to 20 mg/min or albumin: creatinine ratio of greater than or equal to 30 mg/g.

Individuals with slow metabolisms are typically those who fast (go without eating food), go on fad diets that have them eating less than 1200 calories a day, snack on sugar-loaded foods, sit around all day and do not exercise, or those who have malfunctioning thyroids.

Causes

The mechanisms of metabolic syndrome’s intricate pathways are being investigated. The pathophysiology is extremely complex and has only been partially explained.

The majority of affected individuals are elderly, obese, sedentary, and exhibit some insulin resistance. Additionally, stress can be a contributing factor.

Diet (especially consumption of sugar-sweetened beverages), genetics, aging, sedentary behavior or low physical activity, disturbed chronobiology/sleep, mood disorders/psychotropic medication use, and excessive alcohol consumption are the most significant risk factors.

Recent research suggests that disruption of the hormonal equilibrium of the hypothalamic-pituitary-adrenal axis (HPA-axis) can contribute to metabolic syndrome. A dysfunctional HPA-axis leads to elevated cortisol levels, which raise glucose and insulin levels, which in turn cause insulin-mediated effects on adipose tissue.

This ultimately leads to promoting visceral adiposity, insulin resistance, dyslipidemia, and hypertension, with direct effects on the bone, resulting in “low turnover” osteoporosis. The reported association of abdominal adiposity with cardiovascular disease (CVD), type 2 diabetes, and stroke may be explained by dysfunction of the HPA axis.

References:
  1. Alberti, K G, and P Z Zimmet. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic medicine : a journal of the British Diabetic Association vol. 15,7 (1998): 539-53. doi:10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S
  2. Beltrán-Sánchez H, Harhay MO, Harhay MM, McElligott S (August 2013). Prevalence and trends of metabolic syndrome in the adult U.S. population, 1999–2010. Journal of the American College of Cardiology. 62 (8): 697–703. doi:10.1016/j.jacc.2013.05.064
  3. Gohil BC, Rosenblum LA, Coplan JD, Kral JG (July 2001). Hypothalamic-pituitary-adrenal axis function and the metabolic syndrome X of obesity. CNS Spectrums. 6 (7): 581–86, 589. doi:10.1017/s1092852900002121
  4. Mendrick DL, Diehl AM, Topor LS, Dietert RR, Will Y, La Merrill MA, et al. (March 2018). Metabolic Syndrome and Associated Diseases: From the Bench to the Clinic. Toxicological Sciences. 162 (1): 36–42. doi:10.1093/toxsci/kfx233

Last Updated on October 21, 2023