Metabolic syndrome consists of four different factors: High blood pressure, obesity, insulin resistance, and a change in blood lipid levels. If all four factors occur together, they pose a major risk for coronary heart disease.
What is metabolic syndrome?
Metabolic syndrome is not uniformly defined in Germany. The disease is most often assigned to either insulin resistance or ailments that arise from lifestyle. The bottom line is that metabolic syndrome is a combination of several diseases, even if they occur individually:
Hypertension, obesity, insulin resistance, and a change in blood lipid levels. This “deadly quartet,” as metabolic syndrome is also known, is often responsible for coronary heart disease. The official definition of metabolic syndrome has changed more often in recent years.
Causes
The causes of metabolic syndrome are mainly due to a poor and unhealthy lifestyle. Too little exercise with too rich or wrong diet are the main factors. All four syndromes are thus so-called diseases of affluence that affect many people in Western cultures. However, other factors also play a role. For obesity, for example, a genetic predisposition is relevant. Medication can also play a role. Other diseases, for example hypothyroidism, can also cause obesity. Causes of high blood pressure can be hormonal imbalances, kidney damage or disorders of the cardiovascular system. Most of the time, however, the actual causes are obscure. Insulin resistance has to do with a genetically determined metabolic disorder. However, the main cause of metabolic syndrome remains an unhealthy lifestyle.
Symptoms, complaints, and signs
Metabolic syndrome is manifested by the clinical pictures such as obesity, hypertension, dyslipidemia, elevated blood sugar. Affected individuals often first notice signs of obesity, with excess weight concentrated in the abdomen. Accompanying symptoms include abdominal pain, shortness of breath, or chest tightness. Increased blood pressure manifests itself through symptoms such as headaches, chest tightness, pain in the limbs, and a persistent restlessness, among others. A lipometabolic disorder leads to diabetes, which is manifested, among other things, by a strong feeling of thirst, a pronounced urge to urinate, and impaired vision. Diabetes patients are also often fatigued and repeatedly suffer from nausea and vomiting as well as non-specific itching on the skin. Lipid metabolism disorders often first become noticeable through the consequences of vascular calcification. Externally, they can be recognized by the typical fatty nodules on the hands, feet, eyelids and buttocks. One in three people suffering from metabolic syndrome has sleep apnea, which manifests itself as nocturnal breathing pauses and the resulting fatigue and tiredness. Metabolic syndrome develops over months or years and is often not recognized until serious health problems have already developed. Risk factors such as obesity or elevated blood pressure therefore always require medical clarification.
Diagnosis and course
Metabolic syndrome requires medical evaluation. The four individual diseases of the metabolic syndrome are usually diagnosed individually. Obesity is when the body mass index is greater than 25. Obesity, i.e. morbid overweight, begins at a body mass index of 30. The more pronounced the overweight, the greater the risk of secondary diseases. Arterial hypertension, i.e. high blood pressure, is primarily diagnosed by the doctor by measuring blood pressure. If hypertension remains untreated, heart disease, arteriosclerosis and other organ damage can develop. A first suspicion of insulin resistance is often high body weight. Insulin resistance is present in all patients with type II diabetes. Diabetes leads to severe organ damage if left untreated. Altered blood lipid levels are detected by a blood test. If all four diseases occur together, a metabolic syndrome is diagnosed. If all four conditions persist, the risk of coronary heart disease is very high. Cardiac arrhythmias, heart attacks and sudden cardiac death can be the consequences of metabolic syndrome.
Complications
In this syndrome, sufferers usually suffer from various ailments. In most cases, this results in obesity and consequently high blood pressure. The affected person can then also die of a heart attack if no treatment of this disease is initiated. Furthermore, there is shortness of breath, so that the resilience of the affected person is significantly reduced. Fatigue and exhaustion occur. It is not uncommon for the patient’s metabolism to be disturbed as well, so that the ingestion of food leads to pain. Patients may also die of sudden cardiac death. Due to this syndrome, life expectancy is significantly reduced. Furthermore, obesity leads to various limitations in the life of the patents. Diabetes can cause various damages to the internal organs and further reduce the life expectancy. The treatment of this syndrome can be done with the help of medications. Complications usually do not occur. However, those affected must also abstain from alcohol or cigarettes and are dependent on a strict diet. In many cases, this can already limit most of the symptoms.
When should one go to the doctor?
People who are overweight, have high blood pressure, dyslipidemia or diabetes should see a doctor regularly even before they develop metabolic syndrome. The purpose of this is to prevent metabolic syndrome if possible. Metabolic syndrome does not cause pain or significant discomfort. Therefore, its development often goes unnoticed. If metabolic syndrome has already been diagnosed, regular visits to the doctor become even more important. Metabolic syndrome can lead to serious secondary diseases, such as cardiovascular disease. This development must be prevented. It is counteracted with suitable measures. For example, the doctor can advise a diet aimed at lowering blood lipid and cholesterol levels. High blood pressure and diabetes must be monitored to keep them stable. If necessary, drug treatment must be initiated. If there is a suspicion that certain blood values are elevated due to genetic factors, appropriate tests must be performed. These may be LDL cholesterol or a certain lipoprotein, for example. If necessary, these can be removed by apheresis. The physician may send affected individuals to a nutritionist. The diet must be adapted to the metabolic syndrome. The necessary dietary measures may also be monitored by a physician. The doctor may also advise more exercise. Supportively, the affected person may be advised to undergo behavioral therapy.
Treatment and therapy
The treatment of metabolic syndrome is usually through lifestyle changes. But again, a distinction must be made between the four syndromes: Excess weight should be gradually reduced through more exercise and a change in diet. There are various models for this, some of which are supported by health insurance companies. Insulin resistance is also treated by more exercise and a reduction in daily calorie intake. In addition, high doses of insulin are sometimes prescribed to break the cycle of insulin resistance. For hypertension, medications are usually prescribed to normalize blood pressure levels. In addition, the patient must also change his or her lifestyle in order to get the disease under control. Patients are advised to stop smoking, exercise more and lose excess weight. Patients with dyslipidemia, which alters blood lipid levels, should also change their lifestyle. In some cases, vitamin D intake is increased in patients with metabolic syndrome. Treatment of metabolic syndrome should also include extensive counseling of the patient. In this counseling, he or she is informed about the risks of his or her disease and is given assistance in changing his or her lifestyle.
Outlook and prognosis
The prognosis of metabolic syndrome depends on the individual expression of the existing disorders. In an unfavorable course of the disease, all the existing irregularities occur together. These lead to a life-threatening condition. Therefore, premature death and thus an unfavorable prognosis may occur.The disease is composed of four different factors. Normally, the fewer of these factors are present, the better the outlook for the future. For the course of development, it is also decisive how the patient’s cooperation is shaped for a change. The lifestyle must be optimized immediately and adapted to the natural needs of the organism. In addition, weight must be kept within the normal range of BMI. An unhealthy lifestyle due to the intake of harmful substances and a lack of exercise leads to an increase in symptoms and thus to a critical condition. With an early diagnosis and an immediate change in lifestyle by the affected person, further prospects improve. Recovery from metabolic syndrome is possible. For this, in addition to medical care, a change in daily routines is imperative. Only a permanent change in diet, a diet rich in vitamins and the avoidance of alcohol and nicotine can lead to freedom from symptoms in the long term.
Prevention
Since metabolic syndrome is primarily related to lifestyle, a healthy lifestyle is the best means of prevention. This includes a diet that contains plenty of fruits, vegetables, and whole grains, but little sugar. Regular exercise is also important. Smoking and excessive alcohol consumption, on the other hand, should be avoided. With these basic rules, everyone can effectively prevent metabolic syndrome and minimize the risks of coronary heart disease.
Follow-up
After chronic hypertension is relieved, patients often feel tired, exhausted, and fatigued. Because metabolic syndrome is a complex condition in which a wide variety of complications can occur, follow-up care is directed primarily at preventing the condition from worsening. Appropriate medication is used to counteract the onset of lipometabolic disorders, elevated blood sugar levels and high blood pressure. The prescribed drugs can cause side effects such as gastrointestinal complaints or skin changes. Follow-up care, similar to preventive care, focuses on averting the causes of metabolic syndrome in the long term by paying attention to which factors promote the disease.
Here’s what you can do yourself
Affected people can treat metabolic syndrome themselves by changing their lifestyle habits. Depending on the clinical picture, weight must then be reduced or regular exercise integrated into everyday life, for example. Beforehand, sufferers should have a medical checkup to rule out cardiovascular problems and other diseases. An adjustment of the diet is usually also necessary, because only the establishment of healthy eating habits and an avoidance of unhealthy foods and beverages can protect against late effects. A low-calorie and low-fat mixed diet consisting of fiber and complex carbohydrates is recommended. An individual consultation with the physician or a nutritionist facilitates the compilation of a suitable diet plan. The patient should also avoid stimulants. Smoking and alcohol are not recommended in metabolic syndrome, as this only causes further health problems. Patients taking medication should adjust the medication to the new lifestyle in consultation with the doctor so that the metabolic syndrome can be reduced as much as possible. If the symptoms do not subside, it is best to inform the doctor in charge. Concomitant drug treatment or other therapy may then be required.
