Metabolic Syndrome: Criteria, Risks, Prevention

## What is metabolic syndrome? Metabolic syndrome is not a disease in itself but a combination of several metabolic and cardiovascular disorders that occur together. It is characterised by the interplay of increased abdominal fat, elevated blood pressure, impaired sugar metabolism and unfavourable blood lipid levels. These factors reinforce one another and can considerably increase the risk of cardiovascular disease and type 2 diabetes. Metabolic syndrome is widespread in Austria: estimates suggest that around one in four to five adults is affected, with the trend rising in older age groups. Because the individual changes often develop gradually and cause no noticeable symptoms, the syndrome frequently remains undetected for a long time. ## Metabolic syndrome: criteria for diagnosis Several definitions exist for diagnosis. The criteria of the International Diabetes Federation (IDF) are commonly used internationally. According to these, metabolic syndrome is present when there is an increased waist circumference **and** at least two further risk factors. ### Central criterion: waist circumference - Women: increased from 80 cm - Men: increased from 94 cm Waist circumference is considered an indicator of what is known as visceral fat, which accumulates around the internal organs and is metabolically active. ### Further criteria - **Elevated triglycerides**: ≥ 150 mg/dl or already treated lipid disorder - **Low HDL cholesterol**: < 50 mg/dl in women, < 40 mg/dl in men - **Elevated blood pressure**: systolic ≥ 130 mmHg or diastolic ≥ 85 mmHg, or existing antihypertensive therapy - **Elevated fasting blood glucose**: ≥ 100 mg/dl or already diagnosed type 2 diabetes If these values are exceeded, doctors speak of an unfavourable risk profile that warrants closer investigation. ## How do the risk factors develop in the metabolism? A key factor is often what is known as insulin resistance: the body's cells respond less sensitively to the hormone insulin, which transports glucose into the cells. To compensate, the pancreas produces more insulin, which in the long term can negatively affect sugar metabolism, blood lipids and blood pressure. Contributing factors include: - a sedentary lifestyle - an energy-dense diet high in sugar, refined flour and saturated fats - excess weight, particularly around the abdomen - chronic stress and lack of sleep - genetic predisposition - older age Hormonal changes, for example after the menopause, can also affect the risk profile. ## What are the consequences if left untreated? If the risk factors remain untreated over years, they can place a lasting strain on blood vessels, the heart and the metabolism. Possible secondary conditions include: - **Type 2 diabetes**: persistent insulin resistance can progress to manifest diabetes mellitus. - **Atherosclerosis**: deposits in the blood vessels can promote heart attack or stroke. - **Coronary heart disease** with chest tightness (angina pectoris) - **Non-alcoholic fatty liver disease**, which in rare cases can progress to liver inflammation or scarring - **Impaired kidney function** - an increased risk of certain **cancers** and of sleep apnoea Important: these consequences usually develop over many years. Early recognition and consistent measures can significantly reduce individual risk. ## Diagnosis: which examinations are useful In medical practice, the following steps are typically carried out as part of the work-up: - a detailed discussion of lifestyle, family history and symptoms - measurement of body weight, height, BMI and waist circumference - repeated blood pressure measurement - laboratory tests: fasting blood glucose, HbA1c if required, cholesterol (total, LDL, HDL), triglycerides, liver and kidney values - further investigations if needed, such as an oral glucose tolerance test, ECG or ultrasound Based on these findings, the individual risk profile can be assessed and a suitable treatment plan discussed. ## Preventing diabetes and reducing risks: what helps? The good news: in many cases, metabolic syndrome can be favourably influenced by lifestyle changes. Studies show that even moderate weight loss and more physical activity can delay or prevent the progression to type 2 diabetes. ### Diet - preference for plant-based foods such as vegetables, pulses, wholegrains, nuts and high-quality oils (Mediterranean style) - reduction of sugar, sugary drinks and highly processed products - moderate consumption of red meat and processed meats - adequate fluid intake, preferably water or unsweetened tea - mindful alcohol consumption ### Physical activity - at least 150 minutes of moderate endurance activity per week, such as brisk walking, cycling or swimming - supplemented by two sessions of strength or muscle training - increase everyday activity: stairs instead of lift, short distances on foot ### Weight - Even a weight loss of 5 to 10 per cent can noticeably improve blood pressure, blood sugar and blood lipids. - Realistic, sustainable steps are more successful than short-term diets. ### Further measures - stopping smoking - sufficient sleep (7–8 hours) and strategies for managing stress - regular check-ups to keep an eye on values ### Drug therapy If lifestyle measures alone are not sufficient, drug treatment of individual risk factors – such as blood pressure, blood lipids or blood sugar – may be useful. Which therapy is appropriate is decided individually by the treating doctor. ## When to seek medical advice A medical assessment is particularly advisable in cases of: - markedly increased waist circumference - known high blood pressure or a family history of diabetes or heart attack - abnormal values at a check-up - non-specific complaints such as frequent tiredness, increased thirst or reduced performance An early assessment helps to evaluate individual risks and to develop a plan together for sustainable improvement. ## Conclusion Metabolic syndrome rarely develops suddenly; it is the result of many small factors over years. Those who know the criteria, have their values checked regularly and work step by step on diet, physical activity and weight can significantly reduce their risk of diabetes and cardiovascular disease. Every change in the right direction counts. --- *This article does not replace medical advice.*

Metabolic Syndrome: When Several Risk Factors Come Together