Despite the weird name, Syndrome X is not a problem found among extraterrestrials in the latest blockbuster science fiction movie, nor is it the syndrome that comes after Syndrome W. It is an alternative name for that which is also called the Metabolic Syndrome (the term I will use hereafter) or the Insulin Resistance Syndrome. No matter the name used, the topic is the focus of this month’s article in large part because it is increasing in frequency among the population and poses significant health risks to those so afflicted.
Before going into detail regarding the Metabolic Syndrome, we should first understand what a syndrome is and is not. A syndrome is not a disease but rather a group of conditions. The word syndrome comes from a Greek word meaning “run together”. Disease on the other hand refers to an established condition that has a recognized cause, a defined group of symptoms, and creates relatively consistent anatomical changes.
Metabolic syndrome is increasing in prevalence but the reason or reasons for this are not completely understood. The development of the syndrome has not been shown to be due to a single cause but each risk factor for the syndrome is related to weight.
The two most important risk factors for metabolic syndrome are central obesity and insulin resistance. Central obesity is excess weight around the middle and upper parts of the body. Those so afflicted are often described as having an “apple shape”.
Insulin resistance is a condition in which the body uses insulin less effectively than normal. Perhaps insulin’s most important role in our body is to maintain a normal blood sugar level. When insulin resistance is present, higher and higher production of insulin by the pancreas is required to achieve the same blood sugar control found in the absence of insulin resistance. It is believed that such overwork or overtaxing of the pancreas results in Type II diabetes.
There are other risk factors besides the two we just discussed. These include:
- Advanced age and aging
- Certain genetic traits
- Hormonal changes in both men and women
- Lack of exercise
Individuals with the metabolic syndrome are frequently found to have two other problems which can be involved in the cause of the syndrome or aggravate it further. These are increased blood coagulation (blood clotting) and high levels of certain substances in the blood (called blood markers) which indicate abnormally elevated inflammation within the body.
The diagnosis of metabolic syndrome will be made by your physician as a result of a comprehensive medical history, physical exam and appropriate laboratory tests. The diagnosis is made if you are overweight or obese (BMI 25 or higher) and 3 or more of the following signs are present:
- Your waist measurement is greater than 40 inches for men or 35 inches for women*
- You have a blood pressure of 130/85 or greater
- You have an elevated blood sugar (fasting 110 mg/dL or higher)
- You have an abnormal triglyceride (type of fat) level in your blood (150 mg/dL or higher)
- You have a below normal “high density lipoprotein” or “HDL” level in your blood. HDL is the “good” cholesterol. For men a level less than 40 mg/dL or women less than 50 mg/dL are considered abnormally low.
*When measuring your waist, measure at the level of your navel (belly button) not where you wear your pants. Keep the measuring device horizontal to the floor and relax your stomach by breathing out gently. Do not suck in your tummy and make certain the tape is snug but does not compress your skin. Note the reading in inches. This result is your waist measurement.
The greater number of these abnormalities one has the higher the risk of heart disease.
When a diagnosis of metabolic syndrome is made there are several things that can be done to minimize the negative health effects of the syndrome and in many cases entirely correct each abnormality thereby being free of the syndrome. These changes entail improving one’s lifestyle by losing weight, increasing one’s physical activity, following a healthy and caloric appropriate diet, and stop smoking if one is a smoker. These lifestyle modifications are extremely important and can reduce the likelihood of heart disease and Type II diabetes. Always perform these alterations with the guidance and continued direct supervision of your physician. If these changes do not reverse each of the identified abnormalities particularly high blood pressure, triglycerides and elevated blood sugar your physician may start you on medication to correct the abnormalities. Follow his/her advice for ongoing care and necessary follow up.
Have a wonderful summer and don’t forget your sunscreen!
Benton Baker III, M.D., FACOG, FACS
200 River Pointe, Suite 115
Conroe, Tx 77304