Metabolic syndrome is a set of cardiovascular risk factors, whose association increases the risk of cardiovascular disease and type 2 diabetes. It is recognized in 1 of 5 people, and the frequency increases with age. Does it matter if you have metabolic syndrome? Yes! It brings a 5 times higher risk for type 2 diabetes and 2 times higher risk for developing cardiovascular disease.
How can you find out if you have metabolic syndrome?
Metabolic syndrome exists if any 3 of 5 risk factors are present. Increased waist circumference does not have to be obligatory present.
Waist circumference is a measure of abdominal obesity.
Waist circumference is measured over the most protruding part of the abdomen or at the midpoint between the ribs arches and the upper edge of the pelvic bone. The measurement is performed at the end of exhalation. The normal waist circumference for men is 94 cm, and for women 80 cm.
If 5 components of the metabolic syndrome are considered, people usually have elevated triglycerides. Triglyceride levels change from day to day depending on the ingested food. Elevated triglycerides lead to inflammation of the pancreas and may kill the pancreatic beta cells, “slowly but certainly.” Therefore, elevated triglycerides represent a certain risk for developing diabetes.
Which of the 5 components of metabolic syndrome is most predictive for developing heart and blood vessels diseases? High glycemia and high blood pressure are equally dangerous.
How does metabolic syndrome develop?
Three reasons usually lead to the development of metabolic syndrome:
- Chronic stress
- Decline in physical fitness, i.e. cardiorespiratory fitness
Which is worse – metabolic syndrome or obesity?
Abdominal obesity is a component of metabolic syndrome. Many obese people do not have metabolic syndrome and feel quite “fit”, i.e. in shape. And again, many lean people have metabolic syndrome. Metabolic syndrome is associated with high CV risk and high mortality.
What is cardiometabolic syndrome?
Cardiometabolic syndrome is a relatively new term, originated in 2007.
This syndrome emphasizes the importance of connection between the metabolic syndrome and cardiovascular diseases. Risk factors for metabolic syndrome have been added to the classic risk factors for cardiovascular disease (smoking, stress, obesity, poor physical activity, male gender, age). All factors should be analyzed, when assessing whether a person has cardiometabolic risk.
An obese man came to the doctor with biochemical analyzes. The biochemical analyzes are fine and he is satisfied. He thinks he is “fat and healthy.” This man has abdominal obesity, with a waist circumference of 120 cm. However, there are no other criteria which would define the metabolic syndrome. Does this mean there is no cardiovascular risk? By analyzing the classic risk factors, it was found that he smokes and does not get out of the car. The message to such a person is that he has a cardiometabolic risk – since he has abdominal obesity (a component of metabolic syndrome) + he has no physical activity and he smokes (classic cardiovascular risk factors). Now, apparently, everything is fine. However, this person should stop smoking and walk more, in order to avoid heart attack or stroke. And he should reduce caloric intake in order to decrease the risk of developing diabetes.
How can chronic stress explain the occurrence of metabolic syndrome?
In chronic stress, the phenomenon of “food rewards” occurs. Acute stress is associated with loss of appetite. However, in chronic stress, excessive activation of the hypothalamic-pituitary axis occurs with the secretion of cortisol. Cortisol reduces satiety and encourages consumption of high-calorie foods. Even out of stress, the same condition remains. A person feels better if eating or snacking. Cortisol further leads to the formation of visceral adipose tissue. Free fatty acids are released from adipose tissue, which have a toxic effect on β cell and increase insulin resistance in peripheral tissues. Numerous hormones are released from adipose tissue, which increases cardiovascular risk. Chronic stress, to which we are all exposed, has led to the fact that every fifth person in Serbia today is obese.
Can a person be fat and fit?
Yes, but not forever.
For those who consider themselves fat and fit, there is also a medical term – metabolically healthy obese person. That means, obese without metabolic syndrome. MESA (Multi-Ethnic Study of Atherosclerosis) study followed 6809 such individuals over 12.2 years. Eventually half of them developed metabolic syndrome.
So, if you are “fat and fit”, you are halfway between obesity and cardiovascular risk. You are not only at risk of having a heart attack or stroke. You are more at risk of heart failure due to diastolic dysfunction. You should do an Echo of your heart – to make sure your heart is healthy. Maybe your heart is “suffering from weight”, even though you have a normal ECG. If an ultrasound of the heart reveals that you have a disorder in the relaxation (resting) of the heart muscle, you should ask yourself – HOW LONG can your heart stand that?
Can development of type 2 diabetes be prevented in people with metabolic syndrome?
It has been proven that type 2 diabetes can be prevented if 5-10% of initial body weight is lost within 2 years. And if there is enough physical activity. The easiest way is to walk every day – and that is 7000 – 10000 steps a day.
Can cardiovascular disease be prevented in a person with metabolic syndrome?
It is useful to remember the formula 0-3-5-140-5-3-0.
The European Association of Cardiologists made recommendations for the prevention of CVD in 2007. In order to prevent the occurrence of cardiovascular disease, it is necessary for a person not to smoke (that is 0), to walk 3 km per day, to have 5 portions of fruits and vegetables, to have systolic pressure not exceeding 140 mmHg, to have value of total cholesterol not exceeding 5 mmol / l , to have LDL cholesterol not exceeding 3 mmol / l , and not to be obese (that is the last 0).