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Metabolic syndrome (Syndrome X) Causes, Symptoms and Treatment

Metabolic syndrome: 

The metabolic syndrome, also called syndrome X, is not a disease in itself. Rather, it refers to the presence of a set of physiological signs that increase the risk of type 2 diabetes , to heart disease and stroke (CVA).

These warning signs of serious or chronic health problems are not always visible or felt by the person affected. Tests prescribed by the doctor during a routine medical examination reveal them. For example, someone with abnormal glucose and blood lipid levels and high blood pressure will be diagnosed with a metabolic syndrome. This is a serious warning signal. And it is better to treat these anomalies before the situation degenerates.

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Define metabolic syndrome

The definition of metabolic syndrome varies somewhat by country or health organization. In Canada, the criteria used by the International Diabetes Federation are used to define metabolic syndrome. Metabolic syndrome occurs when 3 or more of the following risk factors are present:

  • Abdominal overweight (when fat concentrates around the waist): waist circumference is greater than 80 cm (31.5 in) for women and 37 in (37 in) for men.
    Note: These values ​​are for Caucasian, African, Eastern Mediterranean and Middle Eastern populations. For the Chinese, the Japanese, the people of Southeast Asia, as well as the indigenous populations of America (North, Central and South), the values ​​are the same for women, but 90 cm (35, 5 inches) for men.
  • High blood triglyceride level: this level is equal to or greater than 1.7 mmol / l (150 mg / dl).
  • Hypertension: The blood pressure is equal to or greater than 130 mm Hg / 85 mm Hg.
  • Low levels of “good” cholesterol (HDL): less than 1.0 mmol / l (40 mg / dl) in men and 1.3 mmol / l (50 mg / dl) in women.
  • High blood sugar: equal to or greater than 5.6 mmol / l or 101 mg / dl. Blood glucose is measured with a fasting blood test.

Note. Measurements in mmol / l are used almost everywhere in the world, except in the United States, where measurement in milligrams per deciliter (mg / dl) is used instead.

The list of these risk factors could lengthen as research continues. This could change the very definition of the metabolic syndrome. For example, the inflammation, as measured by the presence of C-reactive protein, could one day be a part.

Causes of Metabolic syndrome (Syndrome X)

Although heredity is one of the causes of this syndrome, the vast majority of cases are rather linked to a sedentary lifestyle and a diet high in calories and low in nutrients (fast food, excess sugar and fat, generous portions, etc.).

Who is affected?

The metabolic syndrome is now so prevalent that it is estimated that between 20% and 25% of the adult population is affected in the United States. In the over 60s, 40% would be affected. Most of these people are unaware of their condition.

If the syndrome is more common in men over 50 and women over 60 years , the Western tendency to physical inactivity and being overweight makes it reaches people more and more young people. Indeed, a 1999 survey in Quebec from 2244 schoolchildren of 9, 13 and 16 reveals that even at this age, 11.5% of them suffer from metabolic syndrome.

A disordered body metabolism

In almost all individuals with the metabolic syndrome, there is evidence of insulin resistance or insulin resistance. Insulin, a hormone produced by the pancreas, is a bit like a key that allows cells to “open” a door to absorb glucose (sugar), thus contributing to the regulation of blood sugar levels (blood glucose). If the cells become insulin-resistant (the lock does not work anymore), they do not absorb glucose well, despite the presence of insulin. The glucose is then found in too high concentration in the blood, and missing cells.

To correct the situation and maintain adequate sugar levels, the pancreas must produce more and more insulin. Over time, the pancreas “runs out” and can no longer provide this extra insulin. If nothing is done to correct the situation, type 2 diabetes is likely to appear in the long run.

Insulin resistance is also associated with a higher risk of hypertension and cardiovascular disease, as it is accompanied by an increase in cholesterol and triglyceride (blood lipid) levels, which can damage arterial walls.

The resistance to insulin is closely linked to being overweight and the obesity , especially when the fat is concentrated in the region of the abdomen. The researchers found that cells that store fat (fat cells) are able to release hormones involved in insulin resistance and metabolic syndrome. The roles and interactions of its substances have been the subject of intense research in recent years.

Possible consequences

  • The type 2 diabetes.
  • cardiovascular disease or stroke.
  • syndrome of polycystic ovaries. This syndrome results from a hormonal disorder and can be a cause of infertility. It is characterized by an increased production of androgenic hormones by the ovaries, which causes the formation of cysts and prevents the maturation of eggs. The link between metabolic syndrome and polycystic ovary syndrome is not fully understood. It may be that insulin resistance is a common underlying factor in these two states. Many women with PCOS also suffer from overweight and insulin resistance: the initial treatment of these two syndromes is similar.

Researchers also suspect a link between the metabolic syndrome and other serious diseases such as breast , uterine, prostate and colon cancer, or Alzheimer’s disease , but this point is still under study.

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Symptoms of Metabolic syndrome (Syndrome X)

The metabolic syndrome does not cause any particular symptoms. The diagnosis is made by a family doctor, according to the risk factors listed above. When symptoms appear, this indicates that the metabolic syndrome has turned into a more serious problem, such as type 2 diabetes or a vascular disorder.

People at risk for Metabolic syndrome (Syndrome X)

People affected by metabolic syndrome (Syndrome X) are:

  • People with a family history of type 2 diabetes.
  • Women who have had pregnancy diabetes.
  • People of Hispanic, African American, Native American or Asian descent.

Prevention of Metabolic Syndrome (Syndrome X)

Why prevent?
Changes in lifestyle are enough to significantly affect the biological factors of the metabolic syndrome and thus reduce the risk of cardiovascular disease and diabetes.

  • In two clinical studies in Finland (522 subjects followed for 3.3 years) and in the United States (3,224 subjects followed for 2.8 years), changes in lifestyle (reduction of intake caloric and at least 20 to 30 minutes of physical activity per day) resulting in a weight loss of about 4% dramatically reduced (58%) the incidence of diabetes in obese people intolerant to glucose.
  • The findings of a previous clinical study (577 subjects with insulin resistance followed for 6 years) conducted in China went in the same direction. Group members who exercised and fed less fat and sugar were less likely to be diabetic (41%) than those in the control group (68%).


Screening measures
Regular medical monitoring can detect a metabolic syndrome. When a risk factor is detected (for example, abdominal overweight), it is important to undertake other medical tests (measuring blood glucose, blood pressure, etc.) to evaluate if other factors are present.

This monitoring is essential to prevent the progression of the syndrome to diseases such as type 2 diabetes or cardiovascular disorders.

Measures to prevent the metabolic syndrome and its possible consequences
Do physical activity. Aerobic physical activity is one of the best ways to prevent insulin resistance. We generally recommend a minimum of 30 to 60 minutes of activity, ideally every day, otherwise at least 5 days a week (brisk walking, swimming, jogging, cycling, etc …). It is important to go gradually. Several short periods can be as beneficial as continuous periods. To learn more about ways to incorporate activities into your daily life, visit our Be Fit section.

Physical activity allows a better use of glucose by the muscles. In addition, his regular practice helps to lose weight and especially to maintain a stable weight thereafter.

Adopt a healthy diet. Healthy eating reduces all the risk factors of the metabolic syndrome. It is recommended to everyone, regardless of their specific disorders, a diet rich in fruits and vegetables, whole grains, monounsaturated or polyunsaturated fats and low fat dairy products. To learn more about the basics of healthy eating, check out our How to Eat Well? and nutritionist Hélène Bari beau’s analysis of Canada’s Food Guide .

It is generally recommended to:
– reduce caloric intake by reducing portion size (beneficial even if no weight is lost);
– restrict the consumption of saturated fat;
– prefer omega-3 polyunsaturated fats (salmon, sardines, linseeds, walnuts, etc.) or omega-9 monounsaturates (olive oil, olives, avocado, canola oil, etc.);
– choose foods that are “low in energy density”, that is, that contain relatively few calories in relation to their volume (for example, eating soup, salad or raw vegetables, eating enough fruit and vegetables, etc.);
limit salt consumption .

Keep a healthy weight. Overweight, along with inactivity, is the leading cause of the metabolic syndrome. The accumulation of fat in the abdomen region is particularly responsible for insulin resistance and would increase the risk of atherosclerosis. Take our test to calculate your body mass index and know how to measure your waist .

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Medical treatment of metabolic syndrome (Syndrome X)

Since the metabolic syndrome has been well defined only recently, its specific treatment is still under study. For now, the main purpose of treatment is preventive: it consists of reducing the risk of suffering from a more serious disorder.

Life habits

When the diagnosis of metabolic syndrome is made, the attending physician first proposes a major change in lifestyle to try to slow down the progression of the syndrome and avoid the possible consequences, which is consistent with many of the prevention strategies mentioned above. .

  • Adopt a diet high in dietary fiber, low in saturated fat and low in foods with high glycolic index.
  • Losing weight, especially if the extra weight is concentrated in the abdomen.
  • Making the physical activity: at least 30 to 60 minutes of exercise a day every day, otherwise 5 days a week.
  • No smoking.
  • Be followed regularly by your doctor.
For other tips, read our nutritionist’s recommendations: Special Diet: Hypercholesterolemia , Special Diet: Diabetes , Special Diet: Hypertension and Special Diet: Obesity .


The use of drugs to treat the metabolic syndrome is still under study. Some have, however, been shown to be effective in preventing metabolic syndrome-related complications in large-scale studies. For example, hypoglycemic agents used to treat type 2 diabetes, such as metformin (Glucophage), may help counteract insulin resistance in people with metabolic syndrome.

Syndrome-related obesity is sometimes treated with drugs to suppress appetite (sibutramine) or to inhibit the absorption of fat (orlistat). The treatment of hypertension or hypercholesterolemia and the use of aspirin are among the strategies for preventing cardiovascular disease. For the moment, however, there is no drug targeting exclusively the metabolic syndrome.

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