What conditions does metabolic (metabolism disorder) syndrome increase the risk for?

Metabolic Syndrome Increases Risk for Multiple Serious Health Conditions

Metabolic syndrome significantly increases the risk of developing heart disease, diabetes, stroke, breast cancer, and microvascular complications including retinopathy, nephropathy, and neuropathy. 1

Definition of Metabolic Syndrome

Metabolic syndrome is diagnosed when a patient has at least 3 of the following 5 criteria:

• Central obesity: waist circumference ≥102 cm in men, ≥88 cm in women 1, 2
• Elevated triglycerides: ≥1.7 mmol/L (150 mg/dL) 1
• Low HDL cholesterol: <1.03 mmol/L (<40 mg/dL) in men, <1.29 mmol/L (<50 mg/dL) in women 1
• Elevated blood pressure: systolic BP ≥130 mmHg and/or diastolic BP ≥85 mmHg 1
• Elevated fasting glucose: ≥5.6 mmol/L (100 mg/dL) or previously diagnosed type 2 diabetes 1

Cardiovascular Disease Risk

• Metabolic syndrome confers a 2-fold increased risk of developing cardiovascular disease over the next 5-10 years 1
• The risk increases with the number of metabolic syndrome components present 1
• Patients with metabolic syndrome have a 1.5-3 fold increase in risk of coronary heart disease and stroke 3
• The syndrome is associated with a 4-fold increase in risk for fatal coronary heart disease 2

Diabetes Risk

• Metabolic syndrome confers a 5-fold increase in risk for developing type 2 diabetes 1
• The combination of insulin resistance and central obesity are particularly strong predictors of future diabetes 1, 2
• Physical activity and weight control can radically reduce the risk of developing diabetes in those with metabolic syndrome 1

Microvascular Complications

• Patients with metabolic syndrome have higher rates of albuminuria (40.8% vs 21.8%) 1
• Diabetic retinopathy is more common in those with metabolic syndrome (37.9% vs 28.6%) 1
• There is a stepwise increase in microvascular complications corresponding to the number of metabolic syndrome components present 1

Cancer Risk

• Recent evidence shows metabolic syndrome is associated with increased breast cancer mortality (HR 1.83,95% CI: 1.35-2.49) 1
• Breast cancer survivors with metabolic syndrome have increased risk of cancer recurrence (HR 1.69,95% CI: 1.39-2.06) 1
• Shorter disease-free survival is observed in breast cancer patients with metabolic syndrome (HR 1.57,95% CI: 1.36-1.81) 1

Cerebrovascular Disease Risk

• Metabolic syndrome is present in 40-50% of patients with ischemic stroke 1, 2
• Cerebrovascular disease is significantly more common in patients with metabolic syndrome (5.8% vs 3.2%) 1
• In the WASID trial, participants with metabolic syndrome were more likely to have stroke, MI, or vascular death during follow-up 1

Clinical Implications

• Screening programs for metabolic syndrome may help identify patients at higher risk for multiple serious conditions 1
• Management should focus on weight loss, increased physical activity, and improvement of atherogenic diet 4
• Even modest weight loss improves insulin sensitivity, lipid profile, blood pressure, inflammation, and endothelial function 2
• Pharmacologic therapy for individual components (lipids, blood pressure, glucose) is often necessary 4, 5

Common Pitfalls in Management

• Focusing only on individual components rather than addressing the underlying insulin resistance 6
• Underestimating cardiovascular risk using conventional risk formulas, which may not fully account for the metabolic syndrome's non-traditional risk factors 4
• Failing to recognize the progressive nature of metabolic syndrome, which often leads to diabetes if not adequately addressed 7
• Overlooking the need for comprehensive management of all risk factors simultaneously 4