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Q: I keep hearing about the metabolic syndrome and its connection to diabetes and heart disease. What exactly is this syndrome?
A: The metabolic syndrome may be getting more media play due to the burgeoning national problem of obesity, which seems to be a key underlying cause. Related factors are physical inactivity, poor diet and likely genetic influences, in some cases.
The metabolic syndrome refers to a number of coexisting disorders that greatly raise your risk for type 2 diabetes and cardiovascular disease (artery-narrowing plaque buildup).
The syndrome is estimated to affect at least one out of every five overweight individuals.
According to current guidelines, a diagnosis of metabolic syndrome is based on the following criteria:
-Waist measurement 40 inches or more for men and 35 inches or more for women.
-Fasting glucose (sugar) 100 or higher (formerly 110).
-Triglycerides 150 or greater.
-HDL cholesterol (the good kind) below 40 for men and below 50 for women.
-Blood pressure 130/85 or higher.
Consider yourself saddled with the metabolic syndrome if you test positive for three or more of the above criteria.
Other risk factors associated with the metabolic syndrome include chronic inflammation and an increased blood-clotting tendency.
In the list of risk factors, waist size is used instead of body mass index because excessive abdominal fat carries extra risk over general obesity.
Traditionally, the metabolic syndrome doesn't start tracking you down until middle age or later. However, there's concern it might begin settling in at an earlier age unless measures are taken to counter the increasing trend toward childhood obesity.
If not headed off, the metabolic syndrome can lead directly to type 2 diabetes and heart disease.
The hub of the syndrome may be insulin resistance. In fact, it's also referred to as insulin resistance syndrome.
Obesity plays a key role. Weight gain can lead to insulin resistance and, ultimately, diabetes.
Ordinarily, the body responds to insulin release by moving glucose (sugar) from the blood into body cells, where it's used to produce energy.
As insulin resistance progresses, the body loses its ability to properly respond to insulin. In an attempt to compensate, the pancreas releases more insulin. Insulin increases the appetite, leading to a vicious cycle of more weight gain and further insulin resistance. Gradually, the pancreas "burns out" and blood sugar levels remain high, resulting in diabetes.
The link to heart disease is that insulin resistance is also associated with high triglycerides, low HDL cholesterol, and an especially harmful form of LDL cholesterol (the bad kind). This so-called lipid triad accelerates plaque buildup in arteries feeding the heart and other parts of the body.
The preferred way to treat metabolic syndrome is to reduce insulin resistance. In this regard, weight loss and regular exercise can work wonders.
If needed, individual risk factors such as high blood sugar, abnormal lipid levels, and high blood pressure can be targeted for treatment.
(Richard Harkness is a consultant pharmacist and specialist in natural therapies. Write him at 1224 King Henry Drive, Ocean Springs MS 39564; or firstname.lastname@example.org. Selected questions will be used in the column.)
(c) 2004, The Sun Herald (Biloxi, Miss.). Distributed by Knight Ridder/Tribune News Service.