Metabolic Syndrome

Description of the Disease

Metabolic syndrome is a cluster of metabolic abnormalities caused by insulin resistance that increase the risk of developing type 2 diabetes mellitus and cardiovascular disease. It is also known as insulin resistance syndrome or the metabolic syndrome. It affects approximately 25% of the general population and up to 85% of people with type 2 diabetes.

Risk factors for metabolic syndrome include a sedentary lifestyle, a diet high in refined carbohydrates, and central obesity, characterized by the accumulation of fat around the abdominal organs. The underlying mechanism is impaired biological responsiveness to insulin in the liver, adipose tissue, and skeletal muscles. Insulin resistance may result from genetic factors, neuroendocrine disorders, poor fetal nutrition during pregnancy, elevated levels of circulating free fatty acids, and central obesity.

Symptoms and Diagnosis

Symptoms are often mild or absent, and many affected individuals are obese, with an elevated body mass index (BMI), but may not seek medical attention. Elevated blood pressure is often the first abnormality that prompts medical evaluation. Hypertension is diagnosed when blood pressure is elevated and requires appropriate treatment.

Blood tests typically reveal elevated glucose and lipid levels. Urinalysis may show small amounts of albumin (microalbuminuria).

If hyperglycemia is detected, additional testing is performed to determine whether blood glucose levels are elevated in the fasting state or after meals. These results help determine whether the individual has developed type 2 diabetes mellitus or is at increased risk of developing it.

Treatment

The primary goals of treatment are to prevent type 2 diabetes mellitus and cardiovascular disease. Initial management includes lifestyle modification through an individualized diet and regular physical activity. Patients should be monitored regularly to assess their progress.

If lifestyle changes are insufficient, medications may be prescribed. These may include biguanides (such as metformin) or thiazolidinediones to improve glucose metabolism. Statins are commonly used to lower blood lipid levels, while elevated blood pressure is treated with appropriate antihypertensive medications tailored to the individual.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology