The metabolic syndrome: recognition and management.
The National Cholesterol Education Program defines the metabolic syndrome as three or more of five abnormalities: waist circumference of >40 in (102 cm) for men or >35 in (88 cm) for women, triglyceride level of > or =150 mg/dL, high-density lipoprotein cholesterol of <40 mg/dL in men or <50 mg/dL in women, blood pressure of > or =130 or > or =85 mm Hg, and fasting glucose of > or =110 mg/dL. It is related to insulin resistance, but the two terms are not synonymous. Both are associated strongly with obesity. The metabolic syndrome is important as an indicator of increased risk of cardiovascular disease (CVD) in patients with and without clinical CVD. The CVD risk of the metabolic syndrome is greater than that conferred by any single CVD risk factor. Since risk factors tend to cluster, if one component of the metabolic syndrome is present, one should assess for other risk factors. The metabolic syndrome is also predictive of new-onset type 2 diabetes. Early diagnosis provides justification for measures that can improve components of the syndrome and reduce CVD risk. The management strategy for metabolic syndrome focuses on overall CVD risk rather than single risk factors; effective therapy includes priority for weight reduction and increased physical activity. Pharmacotherapy is typically needed for control of high blood pressure, hypercoagulability, and increased levels of blood glucose and triglycerides.
Hall
W Dallas
WD
Emory University School of Medicine, Atlanta, GA, USA.
Watkins
Laurence O
LO
Wright
Jackson T
JT
Wenger
Nanette K
NK
Kumanyika
Shiriki K
SK
Gavin
James R
JR
Ferdinand
Keith C
KC
Watson
Karol
K
Clark
Luther T
LT
Flack
John M
JM
Reed
James W
JW
Horton
Ella W
EW
Saunders
Elijah
E
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000628:therapy; D019468:Disease Management; D050171:Dyslipidemias / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D009765:Obesity / Q000150:complications / Q000628:therapy; D012307:Risk Factors