Metabolic Syndrome

About Metabolic Syndrome

Metabolic syndrome affects approximately 25 percent of adults globally, representing a cluster of metabolic abnormalities that dramatically increase cardiovascular disease and type 2 diabetes risk. Diagnosis requires at least 3 of 5 criteria: abdominal obesity waist circumference over 40 inches in men, over 35 inches in women, elevated triglycerides 150 mg dL or higher or on medication, reduced HDL cholesterol below 40 mg dL in men, below 50 in women or on medication, elevated blood pressure 130 85 mm Hg or higher or on medication, and elevated fasting glucose 100 mg dL or higher or on medication. The unifying pathophysiology is insulin resistance, particularly in visceral adipose tissue, which releases free fatty acids and inflammatory cytokines TNF alpha, IL 6 while reducing protective adiponectin. This promotes atherosclerosis, hepatic glucose production, dyslipidemia, hypertension, and a prothrombotic state. The condition is driven by over nutrition, physical inactivity, genetic predisposition, and aging. Patients with metabolic syndrome have approximately 2 times the risk of cardiovascular disease and 5 times the risk of type 2 diabetes compared to those without. Fatty liver disease NAFLD, now called MASLD, is common in people with metabolic syndrome. Management focuses on lifestyle change: modest weight reduction improves all components, as do Mediterranean or DASH style eating patterns lower in processed foods and sugar, regular physical activity in line with public health guidelines, smoking cessation, and alcohol moderation. Medications control individual components statins, antihypertensives, metformin for prediabetes. Bariatric surgery resolves metabolic syndrome in a large proportion of eligible patients.