Metabolic syndrome

Metabolic syndrome is not a single disease but a group of conditions that tend to occur together and sharply raise the risk of heart disease, stroke and type 2 diabetes. Under widely used criteria, a person has it when at least three of five features are present: a large waist, high blood pressure, raised fasting blood glucose, high triglycerides and low HDL cholesterol, or treatment for any of these. Waist cut-offs differ by sex and are lower for people of Asian ancestry.

Excess fat inside the abdomen and insulin resistance, in which cells respond poorly to insulin, are thought to lie at its core. Abdominal fat releases free fatty acids and inflammatory signals that blunt insulin action in the liver and muscles; the pancreas compensates by making more insulin, and blood glucose, blood fats and blood pressure gradually rise. Physical inactivity, an energy-dense diet, aging, genes and some medicines all add to the risk, and the syndrome is common in many countries.

Diagnosis uses a tape measure, blood pressure readings and fasting blood tests. Treatment centers on weight loss, regular exercise and a healthier diet, with medicines added when needed for blood pressure, blood lipids or glucose.