The metabolic syndrome criteria (insulin resistance syndrome or syndrome x) are the presence of the following risk factors: central obesity (excess fat in the abdomen versus distribution around the body), high levels of lipids in the blood (dyslipidemia), high blood pressure, insulin resistance or glucose intolerance, prothrombotic state (increased risk of blood clots), and proinflammatory state (increased tendency of inflammation). While all of the risk factors are dangerous alone, together they increase the likelihood of developing atherosclerosis (peripheral vascular disease), coronary heart disease and heart attack, stroke, type 2 diabetes, and other conditions. The American Heart Association estimates about 35% of adults are affected by metabolic syndrome. It is more common amongst Asians and African-Caribbean people, African American and Mexican American women, and women with polycystic ovary syndrome (PCOS).
Diagnostic Criteria for Metabolic Syndrome
Metabolic syndrome diagnostic criteria were developed by the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults.
Metabolic syndrome is diagnosed when three or more of the following measurements are met: abdominal obesity (waist circumference of 40 in. or greater in men 35 in. in women; triglyceride level of 150 mg/dL or greater; HDL cholesterol of less than 40 mg/dL in men or 50 mg/dL in women; systolic blood pressure of 130 mm Hg or greater; diastolic blood pressure of 85 mm Hg or greater; fasting glucose level of 100 mg/dL or greater; insulin resistance or glucose intolerance. Underlying risk factors identified by the American Heart Association (AHA) and the National Heart, Lung, and Blood Institute (NHLBI) are age, hormone imbalance, and physical inactivity. Individuals with first or second-degree relatives with diabetes are also at increased risk.
Metabolic Syndrome Criteria – The Presence of Intra-Abdominal Fat
In a study of intra-abdominal fat and metabolic syndrome conducted by researchers at the University of Washington, data was collected from 218 men and women of varying weight and age. The incidence of metabolic syndrome was 15.6% of subjects. In comparing these subjects with the healthy ones, researchers determined that while insulin sensitivity index and subcutaneous fat were associated with metabolic syndrome, intra-abdominal fat is also independently related to all syndrome criteria as well as with the syndrome itself, leading to the conclusion that intra-abdominal fat may have a pathophysiological role in it’s development. The connection between obesity and the development of type 2 diabetes is furthered by the correlation between visceral fat and insulin resistance. Central obesity releases an abnormally high number of nonesterified fatty acids from the adipose tissues, contributing to accumulation of lipids (fats) in muscle and liver tissues, heightening the predisposition to insulin resistance.
