About Metabolic Syndrome

Metabolic syndrome refers to a collection of abnormal conditions such as increased body fat, elevated blood pressure, elevated blood glucose, and abnormal blood lipids, all of which raise the risk of cerebrovascular and cardiovascular diseases and diabetes. When metabolic syndrome is present, the risk of cardiovascular disease increases by more than twofold, and the risk of developing diabetes increases more than tenfold. Metabolic syndrome is not a single disease, but a comprehensive condition that develops when genetic predisposition and environmental factors are combined.

Causes

The causes of metabolic syndrome are very complex and are only partially understood. Insulin resistance associated with obesity is recognized as the most important factor. Insulin resistance refers to a state in which the action of insulin is reduced despite insulin being secreted. As insulin’s effects decrease, the muscles and liver are unable to use blood glucose, which causes hyperglycemia and leads to prediabetes or diabetes. Elevated insulin can also increase salt and water retention, causing high blood pressure. In addition, increased insulin promotes fat accumulation, triggering obesity, and raises blood triglyceride levels, resulting in dyslipidemia.

1. Genetic factors

Not all obese people have insulin resistance. In addition, some people who are not obese also show insulin resistance. Therefore, genetic factors (family history) are considered one cause of insulin resistance.

2. Obesity

Central obesity causes excessive release of fatty acids from visceral fat cells, increasing free fatty acids in the blood and promoting insulin resistance.

3. Increased sympathetic nervous system activity

Activation of the sympathetic nervous system promotes lipolysis, and the resulting increase in free fatty acids induces insulin resistance and leads to metabolic syndrome.

4. Stress

Stress is recognized as a fundamental cause of metabolic syndrome. It affects the balance of the brain-adrenal axis, increasing the amount of cortisol in the blood, which in turn increases insulin and blood glucose. As it progresses, it can promote visceral obesity and be accompanied by problems such as dyslipidemia and high blood pressure.

5. Mitochondrial dysfunction

Mitochondrial genes are easily exposed to damage and are harmed by oxygen radicals (reactive oxygen species) generated during the process of energy production. As a result, mitochondrial function gradually declines, insulin resistance increases, and metabolic syndrome develops.

6. Reduced physical activity

Physical inactivity is an important indicator that can predict cardiovascular disease and death. When physical activity decreases, visceral fat accumulates, high-density lipoprotein cholesterol decreases, and triglycerides, blood glucose, and blood pressure rise, leading to metabolic syndrome.

7. Low birth weight

It has already been reported in many countries that infants born with low birth weight have a higher risk of diseases associated with insulin resistance, such as high blood pressure and diabetes.

Symptoms

Metabolic syndrome has no symptoms before complications develop, so early diagnosis and control are important.

Diagnosis

Because metabolic syndrome is a collection of various physical conditions that can cause cardiovascular disease and diabetes, each organization has presented slightly different diagnostic criteria. Currently, the criteria presented by the World Health Organization (WHO), the U.S. National Cholesterol Education Program (NCEP), and the International Diabetes Federation (IDF) are used.

So far, we have explained metabolic syndrome.

In the next installment, we will look at the treatment and prevention of metabolic syndrome.

Source: Korea Disease Control and Prevention Agency National Health Information Portal