Metabolic Syndrome

Metabolic syndrome is a relatively common condition that affects both men and women. The prevalence of metabolic syndrome among US women increased by 24% between 1988-1994 and 1999-2000.⁵⁶ Metabolic syndrome comprises a clustering of risk factors, including:⁵⁷

• Abdominal obesity
• Atherogenic dyslipidemia
• Raised blood pressure
• Insulin resistance or glucose intolerance
• Prothrombotic state (eg, increased fibrinogen or plasminogen activator inhibitor-1 blood level)
• Proinflammatory state (eg, elevated high-sensitivity C-reactive protein blood level)

As 84% of metabolic syndrome patients are obese, there may be a direct correlation between the rising obesity problem and the increasing incidence of metabolic syndrome.^58,59

Click on the links below for more information:

• Diagnosis of Metabolic Syndrome
• Metabolic Syndrome and Cardiovascular Risk

Diagnosis of Metabolic Syndrome

A diagnosis of metabolic syndrome is made by the presence of ≥3 of the 5 risk factors shown in Table 2.⁶⁰

Table 2. Risk Factors Used for the Diagnosis of Metabolic Syndrome in Women⁶⁰

1.	Abdominal obesity—ie, waist circumference* >35 in (>88 cm)
2.	Triglycerides ≥150 mg/dL
3.	HDL cholesterol level <50 mg/dL
4.	Blood pressure ≥130/≥85 mm Hg
5.	Fasting glucose ≥110 mg/dL†

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_{*Overweight and obesity are associated with insulin resistance and the metabolic syndrome. However, the presence of abdominal obesity is more highly correlated with the metabolic risk factors than is an elevated BMI. Therefore, the simple measure of waist circumference is recommended to identify the body weight component of the metabolic syndrome.}

_{†The American Diabetes Association has recently established a cutpoint of ≥100 mg/dL, above which persons have either prediabetes (impaired fasting glucose) or diabetes. This new cutpoint should be applicable for identifying the lower boundary to define an elevated glucose as one criterion for the metabolic syndrome.}

Metabolic Syndrome and Cardiovascular Risk

• Patients with metabolic syndrome are at increased risk for cardiovascular disease (CVD), and they have a 3- to 4.3-fold increased risk for coronary heart disease (CHD) mortality.⁶¹
• In the Framingham Heart Study, the presence of metabolic syndrome alone predicted almost 25% of all new-onset CVD.⁵⁷
• Women with metabolic syndrome are generally less active and have lower cardiovascular fitness levels than women without metabolic syndrome.^62,63

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