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Metabolic syndrome (also called metabolic syndrome X, syndrome X, and insulin resistance syndrome) is a combination of medical conditions that places one at increased risk for cardiovascular disease and type 2 diabetes. The clustering of risk factors that comprise metabolic syndrome has become increasingly more prevalent in the United States. In fact, an estimated 34% of US adults over the age of 20 years have metabolic syndrome (1). Individuals with metabolic syndrome are twice as likely to develop cardiovascular disease and five times more likely to develop type 2 diabetes compared to individuals without metabolic syndrome (2). In addition to a heightened risk for these diseases, metabolic syndrome has recently been shown to impair health-related quality of life (3).
Although the prevalence of metabolic syndrome increases with age, the syndrome is becoming increasingly more common in children and adolescents. However, applying adult diagnostic criteria (see below) to children is controversial because there are multiple definitions for pediatric metabolic syndrome (4). In fact, 40 different definitions for pediatric metabolic syndrome have been used in various studies, and a standardized definition is needed (5). Using different diagnostic definitions, the prevalence of metabolic syndrome in US adolescents varied from 2% to 9% overall and 12% to 44% in obese adolescents (6).
In 2001, the Adult Treatment Panel III of the National Cholesterol Education Program (NCEP) outlined metabolic syndrome as a clinical condition with specific criteria for diagnosis (7). These criteria have since been revised (see below) (8). For instance, the threshold for impaired fasting glucose was lowered to 100 mg/dL; this level may better predict type 2 diabetes (9). The syndrome consists of several different components, including abdominal obesity, atherogenic dyslipidemia, hypertension, insulin resistance with or without impaired glucose tolerance, and evidence of prothrombotic and inflammatory states (7). All of these conditions are risk factors for cardiovascular disease. Moreover, insulin resistance can lead to type 2 diabetes (8).
Diagnostic criteria include the presence of three or more of the following conditions:
People with metabolic syndrome should schedule regular check-ups with their medical provider. In addition to prescribed medications, several lifestyle modifications can help treat metabolic syndrome:
Last updated 4/8/16 Copyright 2008-2017 Linus Pauling Institute
1. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States 2003-2006. National Health Statistics Reports. 2009;13:1-8. Available at: http://www.cdc.gov/nchs/nhanes/new_nhanes.htm.
2. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008;28(4):629-636. (PubMed)
3. Ford ES, Li C. Metabolic syndrome and health-related quality of life among U.S. adults. Ann Epidemiol. 2008;18(3):165-171. (PubMed)
4. Pietrobelli A, Malavolti M, Battistini NC, Fuiano N. Metabolic syndrome: a child is not a small adult. Int J Pediatr Obes. 2008;3 Suppl 1:67-71. (PubMed)
5. Ford ES, Li C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J Pediatr. 2008;152(2):160-164. (PubMed)
6. Cook S, Auinger P, Li C, Ford ES. Metabolic syndrome rates in United States adolescents, from the National Health and Nutrition Examination Survey, 1999-2002. J Pediatr. 2008;152(2):165-170. (PubMed)
7. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-2497. (PubMed)
8. Grundy SM, Brewer HB, Jr., Cleeman JI, Smith SC, Jr., Lenfant C. Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;109(3):433-438. (PubMed)
9. Genuth S, Alberti KG, Bennett P, et al. Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care. 2003;26(11):3160-3167. (PubMed)