2024 - Metabolic syndrome

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What is it about ?

Metabolism is the transformation of food into “building materials” and energy for the body. A syndrome is a set of symptoms that occur at the same time as part of an illness. Metabolic syndrome therefore indicates a specific set of symptoms that arise when the metabolism is disturbed.

The main cause of metabolic syndrome is a reduced sensitivity of our cells to insulin. Insulin is a hormone in the pancreas that regulates the level of sugar (glucose) in the blood (blood sugar).

If you have metabolic syndrome, you run the following risks:

Twice the risk of developing cardiovascular disease (such as stroke, a heart attack (infarction), blocked arteries in the legs, etc.) within 5 to 10 years;
5 times higher risk of developing diabetes ;
Risk of fat accumulation in the liver, with risk of liver cirrhosis ;
Risk ofsleep apnea.

What is its frequency?

Industrialized countries are facing a veritable epidemic of metabolic syndrome. The disease is associated with a poor diet and being overweight. The number of cases has increased significantly in recent years. The onset of the syndrome in middle age is estimated to be around 30%.

We do not know the frequency of metabolic syndrome in Belgium, but almost 1 in 2 adults is overweight and almost 1 in 6 adults is obese.

How to recognize it?

You suffer from metabolic syndrome if you have at least 3 of the following criteria:

Overweight, with a waist circumference (abdominal circumference) greater than 94 cm in men and 80 cm in women;
Triglycerides (= a type of fats in the blood) on an empty stomach greater than 150 mg / dl;
HDL cholesterol (= good cholesterol) less than 40 mg / dl in men and less than 50 mg / dl in women;
Fasting blood sugar (glucose) (glucose) greater than 100 mg / dl or being already on treatment for type 2 diabetes;
Blood pressure greater than 130/85, or being treated for a arterial hypertension.

Metabolic syndrome therefore does not indicate a single disease, but a set of risk factors that often occur together (we speak of “concomitant”) and which are therefore linked to diseases such as cardiovascular disease and diabetes.

How is the diagnosis made?

Diagnosis is based on the concomitant appearance of a number of abnormalities associated with an increased risk of disease. Therefore, in addition to a clinical examination with measurement of weight and blood pressure, a blood test will be necessary to determine the level of sugar in the blood (glycemia) and the level of fat.

What can you do ?

Prevention is better than cure. Adopt a healthy lifestyle. For example, move more and avoid being overweight. Walk 20 minutes a day. Eat enough fiber and not too much fat or sugar. Eat more “fresh” and consume less prepared meals. Avoid sweets and sugary drinks. Also reduce your alcohol consumption and quit smoking.

What can your doctor do?

The doctor will first and foremost ask you to adapt your way of life.

After a while, he will check if your blood values, weight and blood pressure have improved. If so, you probably don’t need any medication, but you will need to continue to maintain a healthy lifestyle. On the other hand, if the results have not improved sufficiently, the doctor will suggest treatment.

No drug can treat all aspects of metabolic syndrome together. This is why we mainly focus on controlling blood pressure, fat levels and blood sugar:

In the event of metabolic syndrome associated with arterial hypertension, drugs to lower blood pressure (antihypertensives) preferably are calcium antagonists and angiotensin converting enzyme (ACEI) inhibitors.
An increase in fat is treated with a cholesterol-lowering drug (statin).
Metformin is the first choice for increased blood sugar (blood sugar) levels. If the blood sugar does not drop enough, a second medication is added. If the result is still insufficient, the doctor may start insulin treatment.

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