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Metabolic syndrome

Overview

Metabolic syndrome is a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels — that occur together, increasing your risk of heart disease, stroke and diabetes.

Having just one of these conditions doesn't mean you have metabolic syndrome. However, any of these conditions increase your risk of serious disease. Having more than one of these might increase your risk even more.

If you have metabolic syndrome or any of its components, aggressive lifestyle changes can delay or even prevent the development of serious health problems.

Apple and pear body shapes

People who have metabolic syndrome typically have apple-shaped bodies, meaning they have larger waists and carry a lot of weight around their abdomens. It's thought that having a pear-shaped body — that is, carrying more of your weight around your hips and having a narrower waist — doesn't increase your risk of diabetes, heart disease and other complications of metabolic syndrome.

Symptoms

Most of the disorders associated with metabolic syndrome have no symptoms, although a large waist circumference is a visible sign. If your blood sugar is very high, you might have signs and symptoms of diabetes — including increased thirst and urination, fatigue, and blurred vision.

When to see a doctor

If you know you have at least one component of metabolic syndrome, ask your doctor whether you need testing for other components of the syndrome.

Causes

Metabolic syndrome is closely linked to overweight or obesity and inactivity.

It's also linked to a condition called insulin resistance. Normally, your digestive system breaks down the foods you eat into sugar (glucose). Insulin is a hormone made by your pancreas that helps sugar enter your cells to be used as fuel.

In people with insulin resistance, cells don't respond normally to insulin, and glucose can't enter the cells as easily. As a result, glucose levels in your blood rise despite your body's attempt to control the glucose by churning out more and more insulin.

Risk factors

The following factors increase your chances of having metabolic syndrome:

  • Age. Your risk of metabolic syndrome increases with age.
  • Race. In the United States, Mexican-Americans appear to be at the greatest risk of developing metabolic syndrome.
  • Obesity. Carrying too much weight, especially in your abdomen, increases your risk of metabolic syndrome.
  • Diabetes. You're more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.
  • Other diseases. Your risk of metabolic syndrome is higher if you've ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome.

Complications

Having metabolic syndrome can increase your risk of developing:

  • Diabetes. If you don't make lifestyle changes to control your excess weight, which can lead to insulin resistance, your glucose levels will continue to increase. You then might develop diabetes.
  • Cardiovascular disease. High cholesterol and high blood pressure can contribute to the buildup of plaques in your arteries. These plaques can narrow and harden your arteries, which can lead to a heart attack or stroke.

Diagnosis

Several organizations have criteria for diagnosing metabolic syndrome. According to guidelines used by the National Institutes of Health, you have metabolic syndrome if you have three or more of these traits or are taking medication to control them:

  • Large waist circumference — a waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men
  • High triglyceride level — 150 milligrams per deciliter,(mg/dL), or 1.7 millimoles per liter (mmol/L), or higher of this type of fat found in blood
  • Reduced high-density lipoprotein (HDL) cholesterol — less than 40 mg/dL (1.04 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women of this "good" cholesterol
  • Increased blood pressure — 130/85 millimeters of mercury (mm Hg) or higher
  • Elevated fasting blood sugar — 100 mg/dL (5.6 mmol/L) or higher

Treatment

If aggressive lifestyle changes such as diet and exercise aren't enough, your doctor might suggest medications to help control your blood pressure, cholesterol levels and blood glucose.

Preparing for an appointment

You're likely to start by seeing your primary care provider. Or you may be referred immediately to a doctor who specializes in diabetes and other endocrine disorders (endocrinologist) or one who specializes in heart disease (cardiologist).

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting for a specific test. Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment
  • Key personal information, including major stresses, recent life changes and family medical history
  • All medications, vitamins or other supplements you take, including the doses
  • Questions to ask your doctor

Take a family member or friend along, if possible, to help you remember the information you're given.

For metabolic syndrome, basic questions to ask your doctor include:

  • What's likely causing my condition?
  • What are other possible causes?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What's the best course of action?
  • Will losing weight help my condition?
  • I have these other health conditions. How can I best manage them together?
  • Should I see a specialist?
  • Are there brochures or other printed material I can have? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask about your diet, exercise and other lifestyle habits.

Lifestyle and home remedies

A lifelong commitment to a healthy lifestyle is usually required to prevent serious health problems, such as diabetes and heart disease. This includes:

  • Being physically active. Doctors recommend getting 30 or more minutes of moderate-intensity exercise, such as brisk walking, daily. Look for ways to increase activity, such as walking instead of driving and using stairs instead of elevators when possible.
  • Losing weight. Weight loss and maintaining a healthy weight can reduce insulin resistance and blood pressure and decrease your risk of diabetes.
  • Eating healthfully. The Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, like many healthy-eating plans, limit unhealthy fats and emphasize fruits, vegetables, fish and whole grains. Both dietary approaches have been found to offer important health benefits — in addition to weight loss — for people who have components of metabolic syndrome.
  • Stopping smoking. Smoking cigarettes worsens the health consequences of metabolic syndrome. Talk to your doctor if you need help quitting.
  • Managing stress. Physical activity, meditation, yoga and other programs can help you handle stress and improve your emotional and physical health.

Last updated: August 9th, 2017

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