Metabolic Syndrome and Associated Health Risks

Definition and Diagnosis

The American Heart Association defines metabolic syndrome as a cluster of conditions that occur together, increasing the risk of developing heart disease, diabetes, and stroke, diagnosed when a patient has at least 3 of the following 5 criteria: central obesity, elevated triglycerides, low HDL cholesterol, elevated blood pressure, and elevated fasting glucose 2
Central obesity is defined as a waist circumference ≥102 cm in men, ≥88 cm in women, which is one of the criteria for diagnosing metabolic syndrome 2, 3
Elevated triglycerides (≥1.7 mmol/L or 150 mg/dL) and low HDL cholesterol (<1.03 mmol/L or <40 mg/dL in men, <1.29 mmol/L or <50 mg/dL in women) are also key components of metabolic syndrome 2, 4
Elevated blood pressure (systolic BP ≥130 mmHg and/or diastolic BP ≥85 mmHg) and elevated fasting glucose (≥5.6 mmol/L or 100 mg/dL) are additional criteria for metabolic syndrome 2, 4

The American College of Cardiology states that metabolic syndrome confers a 2-fold increased risk of developing cardiovascular disease over the next 5-10 years 2
The risk of cardiovascular disease increases with the number of metabolic syndrome components present 2

The European Association for the Study of Diabetes recommends that metabolic syndrome confers a 5-fold increase in risk for developing type 2 diabetes 2
The combination of insulin resistance and central obesity are particularly strong predictors of future diabetes, according to the European Heart Journal 4, 3
Physical activity and weight control can reduce the risk of developing diabetes in those with metabolic syndrome, as suggested by the European Heart Journal 4

Patients with metabolic syndrome have higher rates of albuminuria (40.8% vs 21.8%) and diabetic retinopathy (37.9% vs 28.6%), according to the Ophthalmology journal 1, 5
There is a stepwise increase in microvascular complications corresponding to the number of metabolic syndrome components present, as reported by the Ophthalmology journal 1, 5

Recent evidence from the Journal of Internal Medicine shows that metabolic syndrome is associated with increased breast cancer mortality (HR 1.83, 95% CI: 1.35-2.49) 6, 7
Breast cancer survivors with metabolic syndrome have increased risk of cancer recurrence (HR 1.69, 95% CI: 1.39-2.06) and shorter disease-free survival (HR 1.57, 95% CI: 1.36-1.81), according to the Journal of Internal Medicine 6, 7

Metabolic syndrome is present in 40-50% of patients with ischemic stroke, as reported by the Stroke journal 8, 3
Cerebrovascular disease is significantly more common in patients with metabolic syndrome (5.8% vs 3.2%), according to the Ophthalmology journal 1, 5

Screening programs for metabolic syndrome may help identify patients at higher risk for multiple serious conditions, as suggested by the Ophthalmology journal 1, 5
Even modest weight loss improves insulin sensitivity, lipid profile, blood pressure, inflammation, and endothelial function, according to the Praxis Medical Insights 3