Learn about metabolic syndrome and its complications

Metabolic syndrome brings together several health problems and risk factors for the development of various health complications. These threaten a person's health and life in the long term, but also in the acute sense.

Metabolic syndrome is also referred to as:
Syndrome X
Metabolic syndrome X
Reaven's syndrome

Most frequently asked questions:
What is metabolic syndrome and what causes it?
What are its risks and how does it threaten us?
Metabolic syndrome and hypertension?
What are its symptoms?
How is it treated?

The American physician, endocrinologist Reaven, introduced the term syndrome X in 1988. It combines insulin resistance, diabetes, obesity, high blood pressure and impaired fat metabolism.

Together, these conditions lead to the development of health complications and impaired health, not least life-threatening conditions.

The definition of metabolic syndrome has been further modified over time. And today there are several similar classifications. Differences in assessment impair the global collection of data to determine the exact epidemiological situation.

But even without precise numbers, it is known that a significant proportion of the adult population worldwide suffers from metabolic syndrome. The rising trend is also due to the increase in economic power and economic growth. A large proportion of this is mainly in developed countries, where obesity rates are on the rise.

It has been reported that:
Globally, approximately 15-30% suffer from syndrome X, and this is between the ages of 24 and 65.
In the elderly, it is as high as 40% of the population.

The tricky part of metabolic syndrome is that at the beginning of its development the sufferer has no problems. He does not feel sick and has no reason to change his lifestyle.

Yet lifestyle is one of the most influential risk factors in the development of a number of health problems. These are not only interrelated, but also pose a risk that impairs quality of life and health.

Even in the case of Syndrome X, early detection and early treatment + lifestyle changes are important.

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Metabolic syndrome = a problem

The definition of metabolic syndrome takes several forms.

WHO (World health organization) and its 1998 definition: metabolic syndrome includes insulin resistance, obesity, dyslipidemia and hypertension = symptoms of the disease.

At least one of the three conditions must be present:

1. Type 2 diabetes mellitus
2. impaired glucose tolerance
3. insulin resistance

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Presence of at least 2 of the 4 criteria:

• Abdominal obesity
• Hypertension
• Dyslipidemia
• microalbuminuria

Another type is the NCEP (National Cholesterol Education Program) definition, which requires at least 3 of the 5 criteria:

1. waist circumference over 88 cm in women and 102 cm in men
2. blood pressure above 130/85 mmHg
3. glycaemia above 6.0 mmol/l
4. triglycerides above 1.7 mmol
5. HDL cholesterol below 1.25 mmol/l in women and below 1.0 mmol/l in men

The third, also frequently used, is the definition according to the IDF (International Diabetes Federation). In this definition, the presence of abdominal obesity is required. Furthermore, the presence of 2 of the 4 criteria is determinant:

• triglycerides above 1.7 mmol/l
• hypertension
• glycaemia above 5.6 mmol/l
• HDL cholesterol below 1.1 mmol/l in women and below 0.9 mmol/l in men

Although the definitions used have some differences, they are related and point to common features.

In general, risk factors for the development of metabolic syndrome include:

• an increase in blood pressure above 130/80 mmHg
• an increase in fasting blood sugar above 5.6 mmol/l
• an increase in blood fat levels
• atherosclerosis
• an increased tendency for blood clotting
• presence of protein in the urine
• smoking
• excess fat intake
• lack of exercise and physical activity
• excess stress and mental strain

These features are summarised in the following description.

Obesity

Overweight and obesity are a progressive problem nowadays. Increasing body weight is a problem for adults as well as for children.

Its presence in childhood indicates serious problems that will accompany a person into adulthood.

Abdominal obesity is a type of obesity where fat is deposited in the abdominal area and abdominal organs.

It has been found that fat cells are not just a passive component of the human body. They influence various processes such as energy management and hormonal control. They also influence the development of insulin resistance and glucose intolerance, i.e. the development of type 2 diabetes.

Consequently, obesity also affects the blood vessels and the heart, worsening atherosclerosis, high blood pressure and the development of left ventricular hypertrophy or coronary artery disease.

We know well that its basic characteristic is the storage of fat reserves and an imbalance in the energy balance.

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Excess energy intake and insufficient energy expenditure.

Excessive fat intake and lack of exercise and physical activity are mainly responsible for weight gain.

We know that 1 gram of fat can release up to 38.9 kJ of energy.
Protein is reported to be about 17.1 kJ per gram.
The issue of sugars is complex as they are divided into several types and each has different properties.

For more on nutrients, see the article: Essential nutrients in the human diet

The complications of obesity are well known. Examples are mainly the strain on the musculoskeletal system or the overloading of the heart and blood vessels (cardiovascular system). However, it also negatively affects the metabolism, the endocrine system and the human psyche.

The body mass index (BMI) is used to assess overweight and obesity.

And how to calculate BMI?

Calculate:

By dividing a person's weight by the square of their height.

BMI = m/h²

• m = body weight in kilograms
• h = body height in metres

BMI calculator

The table shows the BMI values

In some cases, the BMI is not an exact guide.
This may be due, for example, to a higher proportion of muscle mass or bone weight.

An example would be an athletic bodybuilder whose BMI would be above 30.
He is certainly not obese, but his body has a high proportion of muscle and a low level of fat.

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Therefore, there is another factor that is important in determining overweight and obesity. And that is:

Waist circumference.

• Moderate risk at waist circumference:
  • for men over 94 cm
  • for women over 80 cm
• significant risk at waist circumference:
  • men over 102 cm
  • for women over 94 cm

Alternatively, the waist to hip ratio (WHR) is also used.

WHR = waist circumference / hip circumference.

Values in centimetres, such as:
Waist circumference 70 cm and hip circumference 85 cm.
Divide 70 : 85.
The result is WHR = 0.8.

Values in the norm are given as:
Less than 0.95 for men and less than 0.85 for women.

Read also the following articles:
Article on BMI
Overweight and obesity
Obesityin children and young people, what to do about it?

Insulin resistance, hyperglycaemia and glucose intolerance

Insulin is a hormone that makes sugar from the blood able to pass into the cells of the body. It is produced by specialised cells in the pancreas. In addition, insulin is also involved in the metabolism of proteins and fats.

Insulin resistance is a condition in which the ability of tissue and cells to use insulin is reduced.

The sensitivity of cells to insulin is reduced.

Skeletal tissue, liver and adipose tissue cannot process sugar and use it for storage glycogen.

Blood sugar levels rise, resulting in increased insulin production. Thus, there is an excess of sugar (hyperglycemia) and insulin (hyperinsulinemia) in the blood.

Insulin resistance can be primary as a genetic condition. Secondary insulin resistance arises, for example, due to chronic stress, inappropriate diet and low physical activity.

= improper lifestyle.

It is the basis of type 2 diabetes - professionally type II diabetes mellitus.

Hyperglycaemia is a condition in which there is an excess of sugar in the blood. A fasting value of more than 5.6 mmol/l is reported. Read more also in the article Elevated blood sugar + What is the correct blood sugar level, what are its values - hyperglycaemia and hypoglycaemia

In the case of glucose intolerance, in short, it is a condition where the body's response to glucose load is impaired. The body is unable to process the sugar it receives from the diet normally.

This is the so-called precursor to diabetes = prediabetes.

The main indicator is an elevated fasting sugar value, with a result of 5.6 to 6.9 mmol/l.

Hypertension

High blood pressure above 140/90 and also higher normal blood pressure at values above 130/85 mmHg is a co-factor in metabolic syndrome.

In the beginning, hypertension is asymptomatic. But higher blood pressure worsens the course of atherosclerosis, which incidentally is its basis. It is itself a risk factor in the development of other cardiovascular diseases.

It rises along with body weight, contributed to by an unhealthy lifestyle.

Read also the articles:

• What are the values of low, normal and high blood pressure?
• Untreated hypertension threatens health and life
• What are the typical symptoms for high blood pressure?
• High blood pressure at night increases the risk of health complications and is a cause of heart attack or stroke

Fats and their metabolism disorder

Dyslipidemia is a condition of impaired fat metabolism.

Unhealthy fats such as TAG (triacylglycerols) above 1.7 mmol/l, LDL (low-density lipids) and total cholesterol are elevated.

Conversely, the amount of healthy fats is reduced (HDL = high-density lipids).

It is also referred to as atherogenic dyslipidaemia as it has a significant role in the development of atherosclerosis.

Complications associated with metabolic syndrome

Each subunit of the metabolic syndrome leads to certain health complications. As mentioned in the article, obesity adversely affects the musculoskeletal system. It is the cause of various orthopedic problems with the joints or spine.

Consequently, it also negatively affects the cardiovascular system and others. Together with diabetes, it forms a solid pair that occurs in a relatively high proportion.

It reduces quality of life and increases morbidity and the risk of premature death.

Complications of syndrome X:

• development of diabetes mellitus
• cardiovascular problems and impaired blood circulation
• atherosclerosis
• high blood pressure
• enlargement of the heart
• ischaemic heart disease
• angina pectoris
• heart failure
• myocardial infarction
• stroke and cerebrovascular disease
• ischaemic disease of the lower limbs
• obesity
• headache
• renal impairment to renal failure
• liver dysfunction
• thrombosis and embolism
• tumour disease, cancer
• psychological problems

How to fight it?

The main thing is to follow the right lifestyle and its modification, i.e. non-pharmacological influence on the risk factors for the development of syndrome X.

It reduces the risk of developing diabetes and cardiovascular diseases.

A significant factor is energy imbalance and lack of exercise. Effective prevention and the basis of treatment also rely on these basic components.

In the event of more serious health complications, pharmacological treatment and therapy for associated diseases (blood pressure, cholesterol, diabetes, heart disease, obesity, etc.) are also added.

Regimen measures come first!

Non-pharmacological approach and prevention of metabolic syndrome:

• Normalization of body weight = reduction of overweight and obesity
  • control of waist circumference
• reduction of energy intake
• regular physical activity, exercise, walking, running, cycling, swimming, etc.
• reduction of stress, psychological load
• sufficient rest, relaxation, sleep
• dietary recommendations, an appropriate diet should include:
  • intake of healthy fats, fish, nuts, seeds, olive oil
  • varied and rational diet, proteins, fats, sugars, vitamins, minerals
  • 5 to 6 meals a day
  • smaller portions
  • enough vegetables 500 grams per day, fruit 150 grams per day, fibre
  • elimination of sausages and semi-finished products, sweets and snacks
  • fish, lean meat
  • wholemeal products
  • cholesterol up to 300 mg per day
  • reduce salt intake
  • nutritional supplements
  • sufficient drinking
  • for example, a Mediterranean type of diet
• not smoking
• limit alcohol intake
• blood pressure control
• preventive check-ups

With metabolic syndrome, there is no pill or other magic cure that will cure it. It must be approached responsibly. A person's cooperation with a specialist, a doctor, is significant and important.

Prevention and treatment of metabolic syndrome is lifelong.
How much energy do we take in in our diet:
Calorie tables: what are the nutritional/nutrient values of food, food