Metabolic syndrome - when risk factors come together

What is metabolic syndrome?

Metabolic syndrome describes a group of risk factors that together significantly increase the likelihood of cardiovascular disease and type 2 diabetes (3-4-fold relative risk increase) [1]. It is defined by the syndrome-typical simultaneous occurrence of (abdominal) obesity, high blood pressure, insulin resistance with a sugar metabolism disorder and a lipid metabolism disorder (HDL cholesterol and triglycerides). Mostly promoted by lifestyle habits such as lack of exercise, a high-calorie diet and stress. A familial accumulation can also be observed here.

Metabolism comes from the Greek word metabolē and means transformation. In this sense, metabolism describes the chemical transformation processes in the body and is basically a term that can be used for any bodily process. The term is most commonly used to describe the utilization, storage and excretion of nutrients in our body.

As a result of increasing metabolic dysregulation due to overstimulation (“oversaturation”) or a lack of stimuli from physical activity, these complex processes no longer run smoothly over time. Increased abdominal fat (visceral or abdominal fat) and increased blood pressure are often observed initially. This is followed by blood sugar levels that indicate insulin resistance, whereupon the triglycerides increase and the HDL cholesterol decreases, which is responsible for the recycling of bad fats (LDL and apolipoprotein B).

The whole cycle reinforces each other in the form of a vicious circle and ultimately forms the basis for metabolic syndrome. At the beginning of the changes, individual processes may only become apparent in different ways. What they have in common - fortunately or unfortunately - is their reversibility and strong dependence on the lifestyle components mentioned above.

What information about metabolic syndrome can CARE give you?

There are five standard criteria that are used worldwide to diagnose metabolic syndrome. If three of them are met, it is called metabolic syndrome. The standard criteria are as follows:

1. A waist circumference (measured at the navel) of more than 102 cm in men and 88 cm in women or increased visceral fat. At CARE, we use a special scale to analyze body composition, which can reliably calculate the mass of abdominal fat.
2. A blood triglyceride level of 1.7mmol/l or higher.
3. Decreased HDL cholesterol: less than 1.05mmol/l in men or less than 1.3mmol/L in women.
4. Elevated fasting blood glucose of at least 5.6 mmol/l or an elevated long-term blood glucose level <5.7%.
5. Average blood pressure values of at least 130 mmHg systolic or 85 mmHg diastolic [2].

Symptoms of metabolic syndrome

In fact, metabolic syndrome initially shows no symptoms. The “deterioration” of the risk factors develops gradually and usually goes unnoticed until serious health problems, such as cardiovascular disease or diabetes, occur. As a result, it is often only recognized when serious complications have already occurred and it is already too late.

When symptoms do occur, they are often non-specific and include

• Tiredness or lack of energy
• Concentration problems
• Weight gain, especially around the abdomen
• shortness of breath
• Sleep apnea and snoring
• Headaches or dizziness
• Increased thirst or frequent urination

What are the causes of metabolic syndrome?

The metabolic syndrome includes the modern diseases of civilization. Accordingly, the typical causes are [2] :

• Insulin resistance: The cells no longer react properly to insulin, which leads to an increase in blood sugar levels. In response, the body produces more insulin, which puts a strain on the pancreas and can lead to other health problems such as type 2 diabetes. insulin resistance is caused by too much sugar, simple carbohydrates and trans fats, accompanied by too little exercise.
• Obesity: Abdominal fat tissue (visceral fat) in particular is metabolically active. Visceral fat can release hormones and inflammation-promoting messenger substances (cytokines) and lead to chronic inflammation (silent inflammation). Chronic inflammation in turn plays a central role in the development of many diseases of civilization such as cardiovascular disease, insulin resistance and type 2 diabetes.
• Genetic predisposition: Certain genetic factors increase the risk of insulin resistance and obesity.

How is metabolic syndrome diagnosed?

The diagnosis of metabolic syndrome is usually based on a physical examination and laboratory tests. At CARE, we measure all relevant biomarkers, including visceral fat. A comprehensive health questionnaire provides additional information on lifestyle and any genetic predispositions.

Once the laboratory values have been received, they are assessed at CARE and checked for abnormalities such as an emerging or existing metabolic syndrome. If you are affected, the doctor will contact you personally and discuss the metabolic syndrome with you.

What are the treatment options for metabolic syndrome?

In an initial (acute) phase, the treatment of metabolic syndrome focuses on reducing the risk factors with the aim of keeping the cardiovascular risk as low as possible and eliminating insulin resistance. Depending on the severity, the focus is on the following measures:

1. Lifestyle changes: A change in diet and regular exercise are the first and most effective steps.
2. Drug treatment: medication to lower blood pressure, blood sugar levels or cholesterol levels.
3. Weight reduction: Reducing abdominal fat can improve many risk factors.
4. Quitting smoking: Smoking aggravates the inflammatory processes in the body and should be given up as soon as possible.

In a second phase, the necessary lifestyle measures are discussed. The best prevention is to adopt healthy lifestyle habits in the long term.

• Healthy diet: A diet rich in fiber, lean proteins, healthy fats and antioxidants can help prevent metabolic syndrome. Lots of vegetables and salads, pulses, some fish and meat (organic) nuts, seeds, dairy products depending on your tolerance.
• Regular exercise: Even a brisk walk of 20 minutes each time after eating can help to reduce the risk.
• Weight management: Weight loss, especially a reduction in visceral fat, is essential.
• Stress management: Stress management techniques such as meditation or breathing exercises can help to lower blood pressure and improve general well-being.
• Sleep: A regular and sufficient sleep cycle supports the metabolism and can improve insulin sensitivity.

The metabolic syndrome continues to rise worldwide [3]. In Switzerland, it is estimated that around 20-25% of adults are affected by metabolic syndrome, with obesity and lack of exercise being among the main causes. Considering that 43% of the population in Switzerland is overweight or obese, this is not surprising. [4]

The increase among older people and in certain ethnic groups is particularly worrying. Although the increase has been slowed down thanks to high standards in healthcare and greater awareness of prevention, there is still an urgent need for greater prevention.