Metabolic syndrome (Syndrome X)

What is it:

Metabolic syndrome refers to the co-occurrence of certain cardiovascular risk factors — insulin resistance, increased blood pressure, obesity with excess fat around the waist, and abnormal cholesterol or triglyceride levels. These risk factors have similar underlying pathways and usually increase the risk of heart disease and diabetes.


According to the NCEP ATP III report (National Cholesterol Education Program's Adult Treatment Panel III report), metabolic syndrome is present if three or more of the following five criteria are met:

  • waist circumference over 40 inches (men) or 35 inches (women)

  • blood pressure over 130/85 mmHg or on medicine to treat BP

  • Fasting triglyceride (TG) level over 150 mg/d

  • fasting high-density lipoprotein (HDL) cholesterol level less than 40 mg/dl (men) or 50 mg/dl (women) or on medicine to treat cholesterol

  • fasting blood sugar over 100 mg/dl.


Metabolic syndrome is primarily due to overweight or obesity and lack of physical activity. The most important risk factor of metabolic syndrome is “insulin resistance”. What is Insulin Resistance? When we eat food, the food is broken down into glucose and nutrients and is absorbed in the blood. The hormone “insulin” that’s produced by the pancreas then makes sure the glucose is absorbed from the blood into our cells and used as energy. If you have insulin resistance, the cells of your body do not recognize insulin, hence the glucose is not adequately absorbed by the cells. As a result, glucose level in the blood keeps rising and you feel lethargic since the cells do not have the energy they need.


Having metabolic syndrome can increase your risk of developing:

  • Type-2 Diabetes: Insulin resistance in the long-term can lead to chronically high blood sugar and Type-2 diabetes

  • Heart disease: Chronic high cholesterol and high blood pressure leads to the buildup of plaque in blood vessels called “arteries”. The plaque can narrow the arteries, which can lead to a obstruction of blood flow to heart due to a blood called, a condition called “heart attack”

How to manage:

Treating metabolic syndrome requires aggressive lifestyle changes such as diet and exercise. You may need medicines to help control your blood pressure, cholesterol levels and blood glucose.

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