Metabolic Syndrome

Table 1.

Risk Factor	Cutpoint
Abdominal obesity
Men	Waist circumference ≥ 40 inches
Women	Waist circumference ≥ 35 inches
Elevated triglycerides	≥ 150 mg/dL
Low HDL cholesterol:
Men	< 40 mg /dL
Women	< 50 mg/dL
Elevated blood pressure	≥ 130 / ≥ 85 mm Hg
Elevated fasting glucose	≥ 110 mg/dL

Table 1. ATP III Diagnostic Criteria for Metabolic Syndrome^[37]

Table 1.

Risk Factor	Cutpoint
Abdominal obesity
Men	Waist circumference ≥ 40 inches
Women	Waist circumference ≥ 35 inches
Elevated triglycerides	≥ 150 mg/dL
Low HDL cholesterol:
Men	< 40 mg /dL
Women	< 50 mg/dL
Elevated blood pressure	≥ 130 / ≥ 85 mm Hg
Elevated fasting glucose	≥ 110 mg/dL

Table 1. ATP III Diagnostic Criteria for Metabolic Syndrome^[37]

Table 2.

Risk Factor Component	Cutpoint for Abnormality
Overweight/obesity	BMI ≥ 25 kg/m²
Elevated triglycerides	≥ 150 mg/dL
Low HDL-C
Men	< 40 mg/dL
Women	< 50 mg/dL
Elevated blood pressure	≥ 130/85 mm Hg
2-hour postglucose challenge
Other risk factors	Family history of type 2 diabetes, hypertension, or cardiovascular disease
	Polycystic ovary syndrome
	Sedentary lifestyle
	Advancing age
	Ethnic groups having high risk for type 2 diabetes or cardiovascular disease

Table 2. AACE Diagnostic Criteria for the Insulin Resistance Syndrome*^[37]

AACE = American Association of Clinical Endocrinologists; BMI = body mass index
*Diagnosis depends on clinical judgment, which is based on risk factors.

Table 3.

Parameter	Mean (SD)
Parameter	Metabolic Syndrome (n = 194)	No Metabolic Syndrome (n = 382)
LDL-C, mg/dL
Baseline	187 (20)	186 (18)
Week 12	99 (31)	96 (25)
% change	-47 (15)	-48 (12)
HDL-C, mg/dL
Baseline	44 (9)	54 (13)
Week 12	49 (11)	58 (14)
% change	+10 (13)	+9 (12)
Triglycerides (mg/dL)
Baseline	216 (60)	155 (57)
Week 12	167 (64)	122 (50)
% change	-23 (20)	-19 (24)
Non-HDL-C (mg/dL)
Baseline	230 (23)	217 (21)
Week 12	132 (35)	120 (27)
% change	-43 (14)	-45 (12)
Non-HDL-C/HDL-C ratio
Baseline	5.4 (1.2)	4.2 (1.0)
Week 12	2.8 (1.1)	2.2 (0.8)
Δ %	-47 (15)	-48 (13)
ApoB (mg/dL)
Baseline	182 (22)	173 (20)
Week 12	115 (26)	106 (21)
% change	-37 (14)	-38 (12)
ApoA-I (mg/dL)
Baseline	141 (23)	155 (25)
Week 12	150 (25)	164 (27)
% change	+7 (13)	+6 (12)
ApoB/ApoA-1 ratio
Baseline	1.3 (0.3)	1.1 (0.2)
Week 12	0.8 (0.2)	0.7 (0.2)
% change	-40 (15)	-41 (13)

Table 3. Baseline and Week 12 Lipid Levels and Percent Change From Baseline in Patients With Hypercholesterolemia Treated With Rosuvastatin 10 mg

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Introduction

Metabolic syndrome is a complex disorder and an emerging clinical challenge. It is considered a "multiplex" cardiovascular risk factor, in that each component of the cluster of abnormalities is a risk factor in its own right. Introduced as Syndrome X by Reaven in 1988^[1] and also termed insulin resistance syndrome, metabolic syndrome is recognized clinically by the findings of abdominal obesity, elevated triglycerides, atherogenic dyslipidemia – ie, low levels of high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, high blood glucose and/or insulin resistance. Metabolic syndrome is also characterized by a prothromobotic state and a proinflammatory state.

Weight gain predisposes individuals to 2 pivotal components of metabolic syndrome: obesity and insulin resistance. Therefore, the high prevalence of metabolic syndrome is largely attributed to the alarmingly high and increasing prevalence of obesity across the world^[2-8] and across demographic groups in the United States^[9-15]— especially in adolescents, the elderly, white men, and black or Hispanic women.

The aims of this Expert Column are to consider epidemiologic data linking metabolic syndrome and/or its components to cardiovascular and type 2 diabetes risk; review the complex interplay of obesity, insulin resistance, atherogenic dyslipidemia, inflammation, and thrombosis in the pathogenesis of metabolic syndrome; survey consensus diagnostic criteria; and examine therapeutic options for the atherogenic dyslipidemia often associated with metabolic syndrome.

Page 1 of 7

Epidemiology

References

Table 1.

Table 1.

Table 2.

Table 3.

Metabolic Syndrome: A Growing Clinical Challenge

Introduction

Table of Contents

Table 1.

Table 1.

Table 2.

Table 3.

References

Faculty and Disclosures

Metabolic Syndrome: A Growing Clinical Challenge

Introduction

Table of Contents