Metabolic Syndrome: Description
The term “metabolic syndrome” summarizes various factors that often lead to cardiovascular disease. These include:
- severe overweight (obesity)
- a disturbed fat and cholesterol balance
- high blood pressure (arterial hypertension)
- an abnormally high blood glucose level due to insufficient insulin action
In Germany, experts estimate that one in four people will develop metabolic syndrome in the course of their lives. It is assumed that this doubles the risk of dying from the consequences of a heart attack or stroke. In addition, a patient with metabolic syndrome is about five times more likely to develop diabetes mellitus type 2 if he or she does not actively combat these risk factors.
Metabolic syndrome: symptoms
The symptoms of metabolic syndrome often go undetected for a long time because it does not cause pain or discomfort itself. The doctor usually diagnoses it by chance during a preventive medical checkup – or only after a heart attack or stroke.
According to the Robert Koch Institute, 67 percent of men and 53 percent of women in Germany are overweight. Of these, 23 percent of men and 24 percent of women are severely overweight (obese).
The limits of abdominal circumference vary somewhat according to ethnicity, but are all in the range of a maximum of 102 centimeters for men and 88 centimeters for women. Above this value, according to the IDF definition, one speaks of truncal obesity, the most important sign of a metabolic syndrome.
However, for one to speak of a metabolic syndrome, at least two other of the following factors must be fulfilled:
- low “good” cholesterol (HDL cholesterol)
- elevated arterial blood pressure. It can lead to headaches, dizziness, nosebleeds or a feeling of heat in the head, but can also occur without symptoms. And as with disturbed lipid metabolism, this factor does not drop out of the risk assessment of metabolic syndrome even if treatment for high blood pressure has already begun.
All these signs of the disease are effects of a modern lifestyle, i.e. lack of exercise and poor diet (too many high-calorie foods).
Metabolic syndrome: causes and risk factors
At the same time, in metabolic syndrome, the excretion of salts – especially common salt (sodium chloride) – via the kidneys is disturbed. High amounts of sodium in the body promote high blood pressure. This not only damages organs, but also promotes small injuries to the inner wall of blood vessels. It is assumed that this additionally promotes the storage of fat and cholesterol. Over the years, the cardiovascular system is thus increasingly damaged.
Discussion of hereditary factors
Every person carries information for all metabolic processes in his or her genetic makeup. This information varies slightly from person to person, so that some people have an increased risk of developing metabolic disorders. Genetic factors are also assumed to be responsible for metabolic syndrome. Nevertheless, the most important factor that can be influenced remains lifestyle.
Metabolic syndrome: examinations and diagnosis
Medical history
To diagnose metabolic syndrome, the physician asks the patient about current complaints in order to obtain a medical history (anamnesis). He also inquires whether there has been or is a family history of cardiovascular disease. Heart attacks or strokes in close relatives can be an indication of a predisposition to metabolic disorders, which can ultimately lead to metabolic syndrome.
Investigations
Blood tests measure blood glucose and blood lipid levels. The blood sample required for this should be taken from the fasting patient. However, other blood values are also relevant: An elevated uric acid level may indicate metabolic syndrome. Liver values show whether a fatty liver has developed due to obesity or as a result of poorly controlled diabetes.
With the help of electrocardiography (ECG) and ultrasound examinations (sonography), the doctor can determine whether there is already damage to the heart or other organs. In the case of severe constriction of the blood vessels supplying the heart muscle or after a heart attack, the ECG shows typical changes. Ultrasound, on the other hand, is a good way to detect disorders of the heart muscle contractions.
Metabolic syndrome: treatment
American and Finnish studies have shown that even small partial successes can reduce the risk of serious sequelae or delay their onset.
Non-drug therapy measures
Non-drug treatment approaches consist primarily of a change in lifestyle: More exercise and a balanced low-fat diet are advisable.
The most important goal is a moderate weight reduction of around ten to 15 percent during the first year. To achieve this, patients should eat a particularly low-carbohydrate and low-fat diet. They should also reduce their salt intake to counteract high blood pressure.
New research results show that, in addition to endurance training, short maximum loads such as sprints can improve the effect even more. But even small changes in lifestyle habits can make a difference: Getting to work by bike or on foot is the first step for many patients.
Drug treatment
- elevated blood lipids: Fibrates and statins are among the most important active ingredients for the treatment of elevated blood lipid levels. The substances help to lower the “bad” LDL cholesterol and raise the “good” HDL cholesterol.
- Increased blood pressure: ACE inhibitors and AT1 receptor blockers reduce the wall tension of the arteries so that the heart has to overcome less resistance when pumping the blood.
Metabolic syndrome: course of the disease and prognosis
Metabolic syndrome is so dangerous because it only really causes symptoms when it is almost too late. Vascular calcification (arteriosclerosis), heart attacks or strokes are events whose causes develop unnoticed over years. The actual symptoms of an unhealthy lifestyle therefore only appear many years after the triggering behavior.
