Metabolic syndrome

Metabolic syndrome is a cluster of diseases that cause high visceral fat (deposit of fat in the abdominal region). Risk factors include high blood glucose, high blood pressure, high cholesterol, leading to a greater risk in diabetes and cardiovascular disease.

Visceral fat is a silent killer. Obese people tend to have higher visceral fat, the larger the waistline, the more visceral fat deposited. These visceral fat can breakdown and enter the liver as free fatty acids, which can affect insulin function and cause metabolic syndrome. With every 5 cm increase of the waistline, the risk of diabetes increases 3-5 times.

High risk population of metabolic syndrome:

• Men with a waistline larger than 90 cm
• Women with a waistline larger than 80 cm
• Blood pressure higher than 130/85 mmHg
• Fasting blood glucose higher than 100 mg/dL
• Triglycerides level higher than 150 mg/dL
• HDL levels lower than 40 mg/dL for men and lower than 50 mg/dL for women

The dangers of high visceral fat

High visceral fat can cause insulin insensitivity, a change in the molecular level that causes the body to not respond to its own insulin released to regulate blood glucose levels. Insulin insensitivity may lead to the inability to control glucose levels in the blood and more free fatty acids released, becoming fat deposits in the liver and muscles. Eventually, the beta cells in the pancreas may weaken and die, as the person develops type 2 diabetes.  

Negative effects of insulin insensitivity

When a person’s body does not respond well to the insulin hormone that their pancreas releases, it can result in constantly high blood glucose levels. This can directly trigger inflammation in the 

• vascular system which in turn cause abnormalities in the vascular walls, restrict the flexibility of that vascular smooth muscles and increase the risk of getting cardiovascular disease by 2-3 times. Furthermore it can also cause high blood pressure and diabetes.
• Decrease the body’s ability to breakdown thrombus, which can cause an embolism.
• Cause deposits of plaque, blocking arteries and causing atherosclerosis.
• Increased blood glucose level.

A 2002 study done in the US have found that obese people who exercised by walking 30 minutes everyday for 5 days and ate low fat foods could help them lose 5-7% of their original weight. After 4 years, their risk of diabetes have decreased by 5-10%, and decreased visceral fat by 30% when compared to the control group who lived normally.

Metabolic syndrome is a medical term used to describe abnormal metabolism, causing cardiovascular disease, cerebrovascular disease, and diabetes. In the past, it used to be called Syndrome X and insulin resistance syndrome.

 In order to be diagnosed with metabolic syndrome, a person has to have visceral fat,  waistline measurements of 90 and 80 cm for men and women, respectively, and at least 2 other conditions. Such as:

• Blood pressure measurements higher than 130/85 mmHg
• Being on medication to treat high blood pressure
• Triglyceride levels higher than 150 mg/dL
• Being on medication to control cholesterol
• HDL levels higher than 40 and 50 mg/dL
• Blood glucose levels higher than 100 mg/dL

Being diagnosed with diabetes type 2

It was found that those who have 3 risk factors are 2 times more likely to get cardiovascular diseases. Those with 4 risk factors are 3 times more likely to get cerebrovascular diseases and 24 times more likely to get diabetes.

Who is more likely to get metabolic syndrome?

• Those with diabetes
• Those who have high blood pressure and glucose levels
• Those with cardiovascular disease

Causes of metabolic syndrome:

Though the definite cause of metabolic syndrome is still unknown, but insulin insensitivity is a big factor.

Genetics – different genetics in people of different ethnicities can play a role in the accumulation of visceral fat. In addition, external factors such as the food they eat, lifestyle, risk factors, and age.

Older populations, those over 60, have a 40% chance of developing metabolic syndrome when compared to those in their 20’s with only a 10% chance.

Some ethnicities are more susceptible to developing metabolic syndrome.

Those who are obese and have a family history of diabetes and high blood pressure also have a higher chance of developing metabolic syndrome.

Negative health effects:

• Atherosclerosis can limit blood access to the heart, therefore limiting oxygen that the organ needs to stay alive
• Kidneys may inefficiently get rid of salts and disrupting homeostasis, causing high blood pressure
• High triglycerides increasing the risk for atherosclerosis
• Atherosclerosis blocking blood access to the heart and brain 
• Increased risk of diabetes

• Treatment: 

  When a person is diagnosed with metabolic syndrome, treatment is required to limit the chances of developing other diseases such as cardiovascular disease and diabetes.

   

  Lifestyle changes

  A 30-minute exercise session everyday, 5 days a week can reduce your chances of developing cardiovascular disease and diabetes.

   

  Eating healthy food low in fat and carbohydrates, increasing fibers intake such as grains, brown rice, vegetables, legumes, using soy bean oil instead of palm oil, and decreasing the intake of meat and coconut milk.

   

  Losing about 5-10% of the original weight can decrease the risk of getting diabetes.

   

  Avoiding alcohol

   

  Treatment by medication

  When lifestyle changes do not work, medical intervention may need to occur.

   

  The goal of treating cholesterol is to lower triglycerides and LDL levels, while increasing the good HDL levels.

   

  Medication used to treat cholesterol can include:

  Fibrate (PPAR alpha agonists) – used for controlling cholesterol to avoid the risk of cardiovascular disease

  Statin – decrease specific lipids such as ApoB-contatining lipoproteins which are involved in causing cardiovascular disease.

  Using these 2 medications together can cause side effects.   

   

  Treating high blood pressure

  Treatment should commence once blood pressure increases up to 140/90 mmHg.

  Those with diabetes should start when their blood pressure is at 130/80 mmHg.

  Medication used to treat high blood pressure can include:

  Angiotensin converting enzyme inhibitors such as enarapril and perindopril, and angiotensin receptor blockers such as cozaar, valsartane. Please be mindful that these current medication can still cause side effects in different users.