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By DrRich

Dateline: 12/16/02

Metabolic syndrome (also called Metabolic Syndrome X) significantly increases the risk of death, even in individuals who seem basically healthy.  (Click here for a recent review of metabolic syndrome.)

This conclusion was reported last week in the Journal of the American Medical Association from data derived from the Kuopio Heart Disease Risk Factor Study.  In the Kuopio study, over 1200 men from Finland, between the ages of 40 - 60 and free of cardiovascular disease, diabetes and cancer, were followed for 10 - 15 years.  Those who had metabolic syndrome were three to four times more likely to die from cardiovascular disease during the follow-up period than those who did not have metabolic syndrome - even when the presence of other risk factors was taken into account. 

While other studies have shown an increased risk of death in patients with metabolic syndrome, these prior studies included patients who had already developed cardiovascular disease or diabetes. This was the first large-scale, long-term study to examine people with metabolic syndrome alone, and who were otherwise apparently healthy. 

Given that one out of three Americans has metabolic syndrome, these results are startling.

Metabolic syndrome is defined somewhat differently by various professional associations, but essentially it includes:

• elevated fasting blood glucose (greater than 110 mg/DL,) reflecting glucose intolerance

• increased abdominal girth, or body mass index greater equal to or greater than 30

• elevated serum triglycerides (150 mg/DL or greater) and low HDL cholesterol levels (below 40 mg/DL)

• elevated blood pressure (greater than 140/90)

Metabolic syndrome appears to occur when individuals who are genetically predisposed (and a large proportion of the population is so predisposed) allow themselves to become overweight, and adopt a sedentary lifestyle.  It is clear that far too many Americans fall into this pattern.  (Click here for a recent article on what constitutes obesity.)  The risk of cardiovascular disease reported in this most recent study - given the rapid fattening of the population - suggests that the health care system will soon have its hands full. 

However, early studies indicate that relatively modest changes in lifestyle - that is, exercise, diet control and weight loss - can reduce the glucose intolerance that is the hallmark of metabolic syndrome, and thus significantly reduce the risk.  That's the good news.

The bad news - aside from the fact that one third of us are at a significantly increased risk of premature disability and death - is that we can all expect reminders, from various public health groups, on the importance of diet and exercise to become even more insistent, ubiquitous - and shrill.  Which reminds me: You might want to check your stock portfolio for producers of consumable products that can be blamed, by the enterprising litigious class, for American obesity.

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