Metabolic Syndrome: Growing Health Threat
New Guidelines Designed to Target and Treat Metabolic Syndrome
Sept. 12, 2005 -- A cluster of obesity-related health risk factors known as
metabolic syndrome, which dramatically raises the risk of heart disease and
diabetes, poses a growing threat to the health of Americans and requires more
New guidelines, released jointly today by the American Heart Association and
the National Heart, Lung, and Blood Institute (NHLBI), broaden the criteria for
diagnosing the condition in an effort to catch and treat more people at
"People are becoming overweight or obese early in life and therefore are
developing metabolic syndrome earlier, increasing their risk of cardiovascular
disease," says Scott Grundy, MD, PhD, chairman of the panel that compiled
the guidelines, in a news release.
What Is Metabolic Syndrome?
Metabolic syndrome consists of several interrelated risk factors that have
been shown to more than double the risk of heart disease and raises the risk of
type 2 diabetes by up to fivefold. It affects more than a quarter of American
adults or more than 50 million people.
The traditional risk factors for metabolic syndrome include:
- Abdominal obesity (waist measurement of more than 40 inches in men or 35 in
- Elevated blood fat (triglycerides greater than 150)
- Reduced "good" high-density lipoprotein cholesterol (HDL); less
than 40 in men and less than 50 in women
- Elevated blood pressure greater than 130/85
- Elevated fasting glucose greater than 100 mg/dL (a sign of insulin
Researchers say anyone with three or more of these risk factors should be
considered to have metabolic syndrome. Other conditions often associated with
metabolic syndrome include physical inactivity, aging, hormonal imbalance, and
a family history of the condition.
Of these risk factors, they say the dominant risk factors for the syndrome
appear to be abdominal obesity and insulin resistance.
Broader Criteria Needed for Some
While these traditional risk factors still stand for most individuals,
researchers say some people who are not obese by traditional measures, who are
insulin-resistant, and have other risk factors may also have metabolic
These groups may include:
- People who have two parents with diabetes or one parent with diabetes and a
first- or second-degree relative with diabetes
- People with a family history of insulin resistance
- Individuals of Asian ethnicity, who are prone to insulin resistance
For these groups, the new guidelines call for a marginally increased waist
measurement of 37-39 inches in men and 31-35 in women to be considered in the
diagnosis of metabolic syndrome.
"If there are three other clinical criteria present, then the diagnosis
of metabolic syndrome can be made without an increased waist
circumference," says Grundy, who is director of the Center for Human
Nutrition at the University of Texas Southwestern Medical Center in Dallas.
The guidelines also broaden the definition of elevated blood pressure and
fasting glucose that doctors should consider in diagnosing metabolic
"This statement should serve as an alert to physicians that it is
vitally important to identify and treat the growing number of people with
metabolic syndrome," says NHLBI Director Elizabeth G. Nabel, MD, in the
release. "For individuals with this syndrome, lifestyle treatment -- weight
control and increased physical activity -- is the primary therapy for lowering
their risk factors and reducing the long-term risk for heart disease."