Metabolic syndrome Dr Trisha Macnair For centuries, doctors have recognised the dangers of conditions such as diabetes, high blood pressure and obesity, but only recently have they realised there's a strong link between them.

In this article

What is it? What are the symptoms?

What causes it? Can it be prevented?

Advice and support

Many people who have either diabetes, high blood pressure or obesity also have one or more of the other conditions, although it may have gone unrecognised.

Individually, each of these conditions can lead to damage to the blood vessels, but together they're far more likely to do harm. People with these conditions in combination become much more likely to experience heart disease, stroke and other conditions related to problems with the blood vessels.

When a person has such a combination, they're said to have metabolic syndrome. This is also sometimes called insulin resistance syndrome (because one of the features is a very high level of the hormone insulin in the blood, which the body doesn’t react to or is 'resistant' to) or syndrome X.

Metabolic syndrome is very common and becoming more so. In the United States, surveys estimate that as many as one in four adults has metabolic syndrome and UK research suggests a similar number of people are affected here. It's more common in certain ethnic groups (such as Asian and Afro-Caribbean people) and among women with polycystic ovary syndrome (PCOS).

The problems found in metabolic syndrome include:

• Central obesity, when fat is laid down around the abdomen, rather than spread evenly around the body
• Abnormal fat levels in the blood - specifically, high levels of triglycerides and low levels of HDL (or 'good') cholesterol, which can lead to arteriosclerosis (fatty plaques) on the walls of blood vessels
• High blood pressure
• Insulin resistance or glucose intolerance - an inability to use insulin properly or control blood sugar levels very well, which is a very important factor in metabolic syndrome
• A prothrombotic state - an increased tendency to make tiny clots in the blood
• A proinflammatory state - an increased tendency to inflammation

Metabolic syndrome is very complex and doctors have yet to work out exactly what goes on in the body at the level of the cells and molecules. However, there seem to be three contributory factors: an inherited genetic tendency, being overweight and physical inactivity.

It seems some people are born with a genetic tendency to develop insulin resistance. If they put on a lot of weight and don’t do enough exercise, they become insulin resistant and develop the metabolic syndrome.

Although much more research has to be done to work out the relationship between different factors in metabolic syndrome, and how drug treatments might be used to help people, there are steps you can take to reduce your risk.

Lifestyle changes can make a big difference, preventing or delaying the development of serious disease. Losing weight and getting active are the top priority. But make sure you get proper advice and support - research has shown that people who join a weight-loss group, for example, are more likely to lose weight and keep it off.

In terms of getting fit, join a gym or find a sport you enjoy. You're more likely to stick at it if you like what you're doing.

Some preventive treatments are also available from your GP. It's important to keep your blood pressure under control, and blood fat (cholesterol) and blood sugar (glucose) at healthy levels. But some blood pressure treatments, such as diuretics and beta blockers, can actually make metabolic syndrome worse.

Check with your doctor if you're concerned. Drugs to control blood fat and cholesterol levels, and blood glucose levels, are often needed.

British Heart Foundation
Information line: 0845 070 8070
Website: www.bhf.org.uk

Diabetes UK
Helpline: 0845 120 2960
Website: www.diabetes.org.uk

This article was last medically reviewed by Dr Rob Hicks in May 2008