Metabolic syndrome

The metabolic syndrome is a multiple risk factor complex for atherosclerotic cardiovascular disease (ASCVD). These risk factors consist of atherogenic dyslipidemia, elevated blood pressure, elevated plasma glucose, a prothrombotic state, and a pro-inflammatory state. The presence of the metabolic syndrome doubles the risk for ASCVD and causes a fivefold increase in the risk for type 2 diabetes. Multiple factors contribute to the syndrome. The most important are overnutrition combined with catabolic defects in individual risk parameters. The accumulation of ectopic lipid in target tissues appears to be a common denominator in risk factor development. Most individuals with metabolic syndrome exhibit insulin resistance, and most also manifest upper body obesity. Both these abnormalities are produced largely by overnutrition. Primary management of metabolic syndrome is caloric restriction combined with increased physical activity. If this approach does not eliminate affected risk factors, consideration must be given to the use of drug therapies to treat individual risk factors.