Cause Of Syndrome Isn't Known

Ask The Expert Dr. Richard Lamson, Greater Baltimore Medical Associates

December 28, 2009

Metabolic syndrome is the name for a "somewhat controversial diagnosis," writes Dr. Richard Lamson, a family medicine physician at Greater Baltimore Medical Associates. It has also been called Syndrome X, pre-diabetes, and insulin resistance syndrome. Lamson writes about who is at risk for developing the syndrome and what to do if you have it:

* Metabolic syndrome is a cluster of other medical conditions which, when taken together, indicate that the person has a higher than average risk of serious conditions such as diabetes, heart disease, stroke, kidney failure and related diseases.

* The definition of metabolic syndrome is debated among experts. So is what to do once we recognize the diagnosis. Even the cause is controversial. Although the conditions often occur together, it's not clear whether they cause each other, or are caused by the same underlying problem, or just happen to occur together.

The definition depends on the group of experts doing the definition, but usually contains some combination of high blood pressure; central obesity (waist size 40 inches or more in males, 35 or more in females); high blood sugar or high blood insulin levels; high triglycerides (the non-cholesterol fat in the blood); and low HDL ("good" cholesterol).

* Nobody really knows what causes metabolic syndrome. We see it in people who overeat, who are overweight, who do not exercise, and in people who have high-stress lives. Family history also plays a big role. It is unknown if insulin resistance causes all or some of the other conditions, or if it is a consequence.

* What to do if you have metabolic syndrome is also controversial. In general, we know that losing weight, eating well, and exercising can reduce the risk of heart disease and stroke, and maybe diabetes. Studies of medical interventions such as medications for diabetes have not shown any benefit.

Cholesterol-lowering drugs have been helpful in some tests but not others. In general, treating the individual disorders is helpful in lowering risk. Reducing stress in your life might also help.

* Tobacco is another risk factor under your control. Stopping smoking reduces the risks of heart attack within a few months of quitting, although it is better never to have smoked. Ask your doctor for help in weight loss, safe exercise regimens and smoking cessation.

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