What is Metabolic Syndrome?

abdominal obesity basic metabolic panel blood glucose blood pressure cholesterol diabetes diet fasting plasma glucose test fatty liver fructose glucose hdl heart disease high blood pressure high-fructose corn syrup insulin insulin resistance lifestyle changes lipid panel metabolic syndrome potassium sodium stroke sympathetic nervous system triglycerides type-2 diabetes vldl Jun 15, 2024

A heart object, a tape measure, a dumbbell

In the U.S., around one-third of adults have metabolic syndrome.¹ Could you be one of them?

It’s important to find out if you have metabolic syndrome, given the many health complications it comes with. Here’s what you need to know:

What exactly is metabolic syndrome?
What are the criteria for metabolic syndrome?
What are the symptoms of metabolic syndrome?
How is metabolic syndrome diagnosed?
How is metabolic syndrome related to insulin resistance?
Can metabolic syndrome be prevented or reversed?

Metabolic syndrome is NOT a single disease. Read on for more.

What exactly is metabolic syndrome?

Metabolic syndrome is a group of related conditions that together increase your risk of certain diseases — in particular, heart disease, stroke, and diabetes.²

Ever heard of insulin resistance syndrome, dysmetabolic syndrome, or Syndrome X? They’re other names for metabolic syndrome.²

What are the criteria for metabolic syndrome?

You have metabolic syndrome if you have AT LEAST THREE of these five conditions: a large waist, high blood pressure, high blood sugar, high triglycerides, or low HDL cholesterol.^2,3

Having a large waist means that your waistline is over 40 inches if you’re male, or more than 35 inches if you’re female. This condition is also called abdominal obesity — there’s excess fat in your stomach area. You likely tick this condition if your body is apple-shaped.²

Blood pressure measures the force of your blood inside your arteries (vessels that carry oxygen-rich blood from your heart to other parts of your body). An example of a blood-pressure reading is 120/80 mg Hg. This reads “120 systolic and 80 diastolic,” or simply “120 over 80.” If your reading is constantly at least 130 systolic or at least 80 diastolic, you have high blood pressure.^4,5,6

Glucose is the main type of sugar in your blood. You get this sugar mostly from carb-containing foods and drinks. Your fasting blood sugar (FBS) is the level of glucose in your blood 8 to 12 hours after you haven’t eaten or drunk anything. Your blood-sugar level is considered high if your FBS is 100 mg/dL or greater.^2,7

Triglycerides are the most common type of fat in your body. They come from dietary fats like butter and oils, and your body can also make them if you consume excess calories. If your blood triglyceride levels are 150 mg/dL or greater, then you’re considered to have high triglycerides.^2,8

Cholesterol is a waxy, fat-like substance found throughout your body. It’s used as a building block for certain hormones that your body needs. Your liver produces all the cholesterol you need to make hormones. But you can get small amounts of it from meat, eggs, and dairy products too. Cholesterol travels through your blood by attaching to proteins, including HDL. HDL — short for “high-density lipoprotein” — transports cholesterol in your blood back to your liver, where it gets removed from your body. This is why HDL cholesterol is sometimes called “good” cholesterol. Low HDL cholesterol is defined as an HDL level less than 40 mg/dL if you’re male, or lower than 50 mg/dL if you’re female.^2,9

What are the symptoms of metabolic syndrome?

You may or may not show symptoms of metabolic syndrome. It all depends on which of the five conditions you have.²

With high blood sugar, the skin in your armpits or on the back and sides of your neck may become dark. Your vision may get blurry. You may feel thirsty all the time, or you may pee more often, especially at night. You may feel fatigue too.²

In contrast, high blood pressure, high triglycerides, and low HDL cholesterol may not show any symptoms. You likely know if you have a large waist though. In fact, it’s the only one of the five conditions you can measure yourself.²

How is metabolic syndrome diagnosed?

If your doctor thinks you could be at risk of or have metabolic syndrome, they’ll do a physical exam and order blood tests.²

They’ll check your blood pressure, and also probably measure your waistline.²

As for blood tests, they may order a basic metabolic panel (BMP). This test gives insights into how your body uses food and energy. It measures eight substances in your blood, including glucose.^2,10

But if you don’t fast for the BMP, your doctor will require a separate fasting glucose test — one that checks your blood sugar after you've fasted for 8 to 12 hours.²

Another common test is the lipid panel. This one uses your blood sample to measure your levels of triglycerides, as well as four types of cholesterol including HDL cholesterol.^2,11

How is metabolic syndrome related to insulin resistance?

A complex mix of factors drive the development of metabolic syndrome. But experts believe insulin resistance is the main contributor.²

You have insulin resistance when your muscle, fat, and liver cells don’t seem to respond to insulin. Insulin is a hormone produced by your pancreas. Its job is to help your cells absorb glucose from your blood and use the sugar for energy. Plus, insulin alerts your liver and muscles to store glucose as glycogen.^12,13

Insulin resistance causes excess fat to be released into your bloodstream. Your liver and skeletal muscles then store this excess fat. But fat accumulation in the liver correlates with excess fat surrounding the other organs in your abdomen, such as your stomach and intestines. All these visceral fat deposits drive inflammation, which worsens insulin resistance and shows up as abdominal obesity (a large waist).^14,15,16

The consequences of insulin resistance don’t end with abdominal obesity though. In response to your cells’ poor glucose uptake, your pancreas secretes more insulin to try to regulate your rising blood sugar levels. As a result, insulin resistance causes elevated levels of insulin in your blood too.¹⁷

The problem is, your pancreas doesn’t have an infinite capacity to make insulin. Once your pancreas can’t keep up anymore, your blood sugar levels will persistently be high — the hallmark of type-2 diabetes (T2D).¹⁸

What’s more, excess insulin can disrupt the balance between sodium and potassium ions in your body, and also activate your sympathetic nervous system, pushing your heart to pump more blood. Insulin resistance can thicken the smooth muscle on the walls of your small arteries as well. This can make the blood vessels resist blood flow. All these changes add up to high blood pressure.^19,20,21

In addition, insulin resistance boosts your body’s production of VLDL. VLDL means “very-low-density lipoproteins.” These proteins carry triglycerides through your bloodstream and into your tissues. The more VLDL you have, the higher your triglyceride levels will be.^9,14

Lastly, insulin resistance makes cholesterol detach from HDL. At the same time, it increases the activity of hepatic triglyceride lipase (HTGL). HTGL is an enzyme that helps break down HDL and remove it from your body via your liver. So, insulin resistance contributes to lowering your HDL cholesterol.¹⁴

Can metabolic syndrome be prevented or reversed?

Treating insulin resistance is the key to preventing or reversing metabolic syndrome.²

And when it comes to tackling insulin resistance, lifestyle changes are the way to go.¹⁷

Among the changes you can make, modifying your diet will have the biggest and most sustainable effect on your metabolism.

You’ll want to keep an eye out especially for foods containing fructose. This simple sugar exists naturally in fruits, but it’s also the main ingredient of high-fructose corn syrup (HFCS).^22,23

HFCS is a cheap sweetener used in almost all processed foods — candies, cookies, cereals, crackers, breads, jams, sauces, ice cream, fast food, and sugary drinks including sodas, teas, and juices. That’s why it's really easy to consume excess fructose as HFCS today.²³

You may have heard that fructose is better because it doesn’t raise your blood sugar. But this is because fructose is processed in your liver. Consuming too much fructose leads to a fatty liver. And as we’ve already seen, excess fat in your liver drives insulin resistance.^24,25,26

Conclusion

Metabolic syndrome is a group of conditions that can lead to heart disease, stroke, diabetes, and other serious health problems.

If you have three or more of the following conditions — a large waist, high blood pressure, high blood sugar, high triglycerides, and low HDL cholesterol — then you have metabolic syndrome.

Various factors contribute to metabolic syndrome. Research suggests that among these factors, insulin resistance plays the biggest role.

Fortunately, it’s possible to prevent or reverse metabolic syndrome by addressing insulin resistance. The most effective way to do this is to change your lifestyle, especially your diet.

Steer clear of fructose-containing foods and drinks in particular, as excessive fructose intake is a top driver of insulin resistance.

But maybe this talk about fructose raises even more questions (and eyebrows). Should you avoid fruits altogether? Wouldn’t a fructose-free diet be too restrictive? The answers are just a click away. Sign up for the Diabetes Diet Solution now and avoid type-2 diabetes while reversing metabolic syndrome too.