Metabolic Syndrome

By Gilda Morales, ANP, DC

Today’s topic is about Metabolic Syndrome, a combination of symptoms that are the precursors to type 2 diabetes and heart disease in adults.  The presence of 3 or more of the following symptoms are required to be present to make the diagnosis of Metabolic Syndrome: 1) obesity, which is defined as a BMI greater than97%, 2) low HDL cholesterol, which is considered the “good” cholesterol, 3) elevated triglycerides, 4) hypertension, 5) high blood sugar, greater than 100 mg/dl or 6) two-hour glucose tolerance test greater than 140 mg/dl.

There are also several risk factors that can predict when someone may develop metabolic syndrome, including obesity, family history of heart disease, and family history of heart disease.  However, patients that have polycystic ovarian syndrome, nonalcoholic fatty liver disease and sleep apnea are also at greater risk of developing metabolic syndrome.

Obese patients may not have any symptoms, but may have the syndrome and they may complain of easy and rapid weight gain, excessive hunger, tiredness, headaches, darkening of the neck and axillae, a condition called acanthosis nigricans, and nocturia, or having to get up to void multiple times at night.

Treatment for this syndrome includes lifestyle changes and the diabetes medication, Metformin, which can prevent the development of full-blown diabetes.  The main lifestyle change, which has to be undertaken, is diet.  The patient must limit the intake of sugar, especially in sugared beverages, increase fruits, vegetables, fruits, whole grains and protein, and control portions size of junk food. There should also be increased physical activity, and limit sedentary activities, such as watching TV to no more than two hours per day.  Cholesterol statin medications should also be considered in patients whose LDL or “bad” cholesterol is greater than 190 mg/dl.