Metabolic Syndrome 2006                                   See Metabolic Syndrome 2007

People with the metabolic syndrome are at increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes. The metabolic syndrome has become increasingly common in the United States. It’s estimated that over 50 million Americans have it.

The dominant underlying risk factors for this syndrome appear to be abdominal obesity and insulin resistance. Insulin resistance is a generalized metabolic disorder, in which the body can’t use insulin efficiently. This is why the metabolic syndrome is also called the insulin resistance syndrome.

Other conditions associated with the syndrome include physical inactivity, aging, hormonal imbalance and genetic predisposition.

NCEP/ATP III Definition

(3 or more of the following)

1. Waist circumference >88 cm (>35 in) in women, >102 cm (>40 in) in men

2. Triglycerides >150 mg/dL (1.7 mmol/L) or on Drug Rx for elevated triglycerides

3. HDL-C <50 mg/dL in women, <40 mg/dL in men

4. Blood Pressure >130/85 mmHg

5. Fasting plasma glucose >100 mg/dL or on Drug Rx for elevated glucose


International Diabetes Federation Definition

Central Obesity

plus 2 of the 4 following factors:

1. Triglycerides >150 mg/dL

2. HDL-C <50 mg/dL in women, <40 mg/dL in men

3. Blood Pressure >130/85 mmHg

4. Fasting plasma glucose >100 mg/dL or previously diagnosed Diabetes type 2.


World Health Organization WHO Definition

Impaired Glucose Tolerance (IGT), Imparied Fasting Glucose (IFG), or Diabetes Mellitus and/or Insulin resistance,

plus 2 or more of the following:

1. Central Obesity >0.85 in women, >0.9 in men or BMI >30

2. Triglycerides >150 mg/dL

3. HDL-C <39 mg/dL in women, <35 mg/dL in men

4. Blood Pressure >140/90 mmHg

5. Microalbuminuria >20 ug/min or albumin: creatinin ratio >30 mg/g

2005 AHA Recommendation for Managing the Metabolic Syndrome:

The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. Then, the first-line therapy is to reduce the major risk factors for cardiovascular disease: stop smoking and reduce LDL cholesterol, blood pressure and glucose levels to the recommended levels.

For managing both long- and short-term risk, lifestyle therapies are the first-line interventions to reduce the metabolic risk factors. These lifestyle interventions include:

  1. Weight loss to achieve a desirable weight (BMI less than 25 kg/m2)
  2. Increased physical activity, with a goal of at least 30 minutes of moderate-intensity activity on most days of the week
  3. Healthy feating habits that include reduced intake of saturated fat, trans fat and cholesterol

In September 2005, the ADA said in a statement issued jointly with the European Association for the Study of Diabetes that metabolic syndrome is an inadequately defined concept and that

  1. does not meet the medical definition of a syndrome and
  2. does not change how each individual aspect is medically managed.