Spotlight On: Metabolic Syndrome

I've heard a lot about metabolic syndrome or syndrome X. What is it?

Anthony L. McCall, M.D., Ph.D., co-director of the University of Virginia Health System's Diabetes Cardiovascular Clinic talks to us this month about the dangers of having multiple risk factors for heart disease.

What is metabolic syndrome?

Metabolic syndrome is a cluster of health problems associated with the body’s metabolism. These health problems are also risk factors for heart attack, stroke and diabetes. It is an increasingly common condition and it is estimated that over 50 million Americans have it.

How is metabolic syndrome diagnosed?

Metabolic syndrome is diagnosed by the presence of three or more of the following risk factors: 

• Obesity, especially around the waist (an “apple-shaped” body)
• High blood pressure
• Resistance to insulin as found in type-2 diabetes
• High triglycerides (a type of blood fat)
• Low HDL (“good”) cholesterol and high LDL (“bad”) cholesterol
• High levels of C-reactive protein, believed to indicate inflammation
• High levels of blood clotting factors

How do risk factors, such as diabetes, contribute to the risk for heart disease?

If you have type-2 diabetes, your chances of developing symptoms of hardening of the arteries from a buildup of fatty substances that block blood flow (atherosclerosis) are extremely high – high enough that they are equal to those of someone who’s already had a heart attack. In addition, researchers have shown that insulin (the hormone that helps regulate blood sugar) greatly increases blood flow in heart muscle. Insulin resistance then is believed to limit circulation in the heart muscle and contribute to the development of heart disease. Both high blood sugar and insulin resistance can contribute to inflammation, which in turn increases the risk of atherosclerosis.

What is the best way to treat metabolic syndrome? Do you treat each of the risk factors individually?

The only way to truly break the cycle of disease is to launch a comprehensive attack on all of the risk factors. Just treating the blood pressure or the glucose or the sedentary lifestyle or bad diet or high cholesterol won’t work. Instead, you have to treat them all. Certain lifestyle changes including regular physical activity, weight loss and smoking cessation can serve as the first line of treatment, but many times patients must seek additional therapies.

What resources can I find at UVA to help with the management of metabolic syndrome?

UVA’s innovative Diabetes Cardiovascular Clinic is designed specifically to offer diabetes patients the support, guidance and specialized treatment they need to control the risk factors that constitute metabolic syndrome. Endocrinologists and cardiologists practice side by side with dietitians, exercise physiologists, cardiac rehab nurses, diabetes educators and a pharmacist offering each patient individualized care from a whole team of experts. If you have diabetes and would like help improving your heart health, talk to your doctor about a referral to the Diabetes Cardiovascular Clinic.