Metabolic syndrome (MetS) (synonyms: Insulin resistance syndrome (IRS); metabolic syndrome; Reavan syndrome; syndrome X or fatal quartet; affluence syndrome; ICD-10-GM E88.9: metabolic disorder unspecified; there is no globally valid ICD-10) refers to the joint presence of the following criteria, according to Grundy:
- Abdominal obesity – overweight with increased waist circumference (≥ 94 cm in men; ≥ 80 cm in women) (= central obesity; visceral obesity).
- Hyperglycemia (elevated fasting blood glucose levels) – ≥ 100 mg/dl or ≥ 5.6 mmol/L
- Dyslipoproteinemia (impaired ratio of lipoprotein fractions in blood serum).
- Hypertriglyceridemia (VLDL triglycerides) – elevated blood lipid levels ( ≥ 150 mg/dl).
- Elevated total and LDL cholesterol.
- Low HDL cholesterol – so-called “good cholesterol” ( < 40 mg/dl in men; < 50 mg/dl in women).
- Hypertension – high blood pressure with values > 130/85 mmHg.
If three of these five criteria apply, a metabolic syndrome is present.
To assist pediatricians in assessing the risk of metabolic syndrome in children aged 3-10 years, an online tool is available.
In addition to the above criteria, the following changes usually also occur:
- Hyperuricemia – increased uric acid levels in the blood.
- Mild signs of inflammation in the blood (such as slightly elevated CRP – C-reactive protein).
- Hypercoagulopathy – increased coagulability of the blood.
- Endothelial dysfunction – changes in the inner walls of the vessels, which can lead to the formation of atherosclerosis (arteriosclerosis, hardening of the arteries)
The crucial manifestation factors of metabolic syndrome are overeating and obesity.
Sex ratio: men to women is 1: 0.9.
Frequency peak: the frequency of metabolic syndrome is highly dependent on increasing age and body weight.
The prevalence (disease incidence) ranges from 17.7-21.1% in women and 21.4-22.7% in men (in Germany) in primary care practices. In Germany, the prevalence is estimated at 9%.
Course and prognosis: The present partial diseases of the metabolic syndrome must be treated independently. However, the course of the disease depends largely on how well the patient eliminates or minimizes the individual risk factors (obesity; poor dietary behavior; lack of adequate physical activity) associated with the metabolic syndrome.Affected individuals are three times more likely to develop cardiovascular complications such as myocardial infarction (heart attack) or apoplexy (stroke).
