Metabolic Syndrome

Content written by Sharon J Parish, MD

Do you have three or more of the following: i) elevated waist circumference, equal to or greater than 35 inches, ii) elevated blood pressure equal to or greater than 130/85 mmHg, iii) elevated fasting glucose equal to or greater than 100 mg/dl, iv) elevated triglyceride blood tests (taken during cholesterol measurements) equal to or greater than 150 mg/dl or v) reduced HDL cholesterol (the “good” cholesterol) less than 50 mg/dl? If you do, according to the American Heart Association and the National Heart, Lung, and Blood Institute, you have a condition consistent with metabolic syndrome. Metabolic syndrome has become increasingly common in women in the United States.

Having metabolic syndrome means you have several disorders at the same time, all related to your metabolism. These disorders include: i) obesity, particularly excess fat tissue around your waist or abdomen (having an “apple shape”), ii) elevated blood pressure, iii) elevated level of triglycerides, the blood fat, and low level of high-density lipoprotein (HDL) cholesterol, the “good” cholesterol, fostering plaque buildup in artery walls, and iv) resistance to insulin, the key hormone from the pancreas that helps regulate your blood sugar level, resulting in elevated blood sugar. In addition, in metabolic syndrome, there is increased inflammation of the lining cells of the blood vessels. This is characterized by high blood levels of chemical markers of inflammation, such as C-reactive protein. Finally, in metabolic syndrome, there is an increased tendency for blood clotting, as evidenced by high levels of fibrinogen or plasminogen activator inhibitor–1.

Women with metabolic syndrome are at increased risk for type 2 diabetes and coronary heart disease as well as other diseases related to plaque buildup in artery walls, including stroke and peripheral vascular disease. There are new data that women with metabolic syndrome have not only high levels of C-reactive protein but less sexual function and less sexual satisfaction.

The primary goal of clinical management of the metabolic syndrome is to reduce the risk for cardiovascular disease and type 2 diabetes. This can be achieved with the following lifestyle interventions: i) weight loss to achieve a desirable weight (BMI less than 25 kg/m2), ii) increased physical activity with a goal of at least 30 minutes of moderate-intensity activity on most days of the week, and iii) healthy eating habits such as the Mediterranean diet. Medications may be needed to reduce LDL cholesterol, blood pressure and glucose levels to recommended levels. Women who smoke should stop smoking. Women with sexual health problems may need to be referred to a sexual medicine health care provider.