Understanding Metabolic Syndrome: Measures to Reduce Risk and Prevalence

Metabolic syndrome is associated with several serious health consequences. The American Heart Association (AHA) defines metabolic syndrome as a group of 5 conditions that can augment one’s risk of developing cardiovascular disease (CVD), diabetes (T2DM), stroke, and other chronic health issues.¹

Moreover, the AHA indicates a diagnosis can be made if the individual has 3 or more of the following risk factors:

1. Prediabetes and diabetes (having impaired glucose, such as fasting blood glucose of ≥100 mg/dL, or taking antidiabetic medications)
2. Abdominal obesity (having a waist circumference of at least 35 inches and 40 inches for women and men, respectively)
3. Elevated triglycerides (≥150 mg/dL)
4. Low levels of high-density lipoprotein cholesterol (<50 mg/dL for women and <40 mg/dL for men)
5. Hypertension (having blood pressure ≥130/85 mm Hg or taking antihypertensives)^1-3

Most recent statistics from the AHA indicate that over 34% of adults in the United States have metabolic syndrome, many more are at risk, and the risk increases with age.⁴ As the obesity epidemic continues to soar even among pediatric patients, the number of individuals at risk for metabolic syndrome also increases.

Overweight/obesity in children and adolescents puts them at greater risk of developing health complications that are characteristically diagnosed in adults, such as CVD and T2DM. The CDC indicates that from 1999 to 2000 through 2017 to March 2020, the prevalence of obesity in the United States grew from 30.5% to 41.9%, and the prevalence of severe obesity increased from 4.7% to 9.2%.⁴

Recent Clinical Data Regarding Metabolic Syndrome

Metabolic Syndrome in Patients With COVID-19

Research has established that hypertension, diabetes, and obesity are common comorbidities that are often correlated with worse outcomes in those with COVID-19. Authors of a recent study published in Metabolic Syndrome Related Disorder noted that “metabolic syndrome is the common denominator of these conditions.”⁵

Their findings revealed that patients with metabolic syndrome had significantly higher rates of hospitalization and mortality due to COVID-19. The authors concluded that focusing on correcting risk factors such as obesity, hyperglycemia, dyslipidemia, and hypertension could possibly diminish mortality in patients with COVID-19.

Night Shift Workers at Greater Risk

In another study⁶ published in the Journal of Family Medicine and Primary Care, researchers studied the relationship between night shift work and risk factors for metabolic syndrome.

The study involved 303 patients. Compared to day shift workers, night shift workers had higher levels of highly sensitive C-reactive protein (hs CRP), authors said. Fasting blood sugar and serum triglyceride levels were also significantly higher (P<0.001). Data indicated 6.5% of participants who worked at night had a waist circumference >40 inches. It was also observed that higher hs CRP was associated with high waist circumference (P<0.001) and fasting blood sugar (P<0.05) in night shift workers.

Among the participants, 3.57% of night shift workers met at least 3 criteria to be diagnosed with metabolic syndrome.

“Night shift work is associated with an increase in pro-inflammatory markers and the development of risk factors leading to metabolic syndrome,” researchers concluded. “Thus, early screening and management of risk factors among night shift health care workers may improve their health status and prevent the development of [metabolic syndrome].”

Linking Psoriasis and Metabolic Syndrome

In a systematic review and meta-analysis⁷ published in the Journal of the European Academy of Dermatology and Venereology, authors determined the prevalence of metabolic syndrome in patients with psoriasis.

Researchers indicated the global prevalence of metabolic syndrome was 32% in this patient population (95% CI, 0.26-0.38). The prevalence in adults and in children and adolescents was 32% (95% CI, 0.29-0.36) and 9% (95% CI, 0-0.18), respectively. The greatest prevalence was observed in Latin America (47%; 95% CI, 0.43-0.51), while the lowest prevalence was observed in North America (26 %; 95% CI, 0.16-0.37).

Compared with individuals with other psoriasis types, patients with psoriasis vulgaris or severe psoriasis had a greater prevalence of metabolic syndrome (29% [95% CI, 0.23-0.35] and 37% [95% CI, 0.27-0.46], respectively).

The authors concluded their findings suggest the need to recognize and manage metabolic disorders in patients with psoriasis, and further studies should evaluate the pathogenesis of metabolic syndrome in this patient population.

Conclusion

Research has established that patients who are well informed and motivated about their health are more likely to be compliant to treatment recommendations. The value of patient education must never be underestimated, and health care providers should seize every possible opportunity to encourage patients to take an active role in their overall health.

Increasing awareness about the serious health consequences associated with undetected and untreated metabolic syndrome is critical as the number of individuals with obesity continues to increase. An individual’s risk of metabolic syndrome can be lowered or prevented with early recognition and clinical intervention with treatments, as well as lifestyle measures such as losing weight, diet, exercise, and obtaining adequate sleep. These measures have the potential to improve clinical outcomes, decrease health consequences, and enhance overall health-related quality of life.

References

1. American Heart Association. About metabolic syndrome. Updated March 25, 2021. Accessed June 28, 2022. https://www.heart.org/en/health-topics/metabolic-syndrome/about-metabolic-syndrome
2. American Heart Association. What is metabolic syndrome? 2021. Accessed June 28, 2022. https://www.heart.org/-/media/Files/Health-Topics/Answers-by-Heart/What-Is-Metabolic-Syndrome.pdf  
3. Metabolic syndrome. Cleveland Clinic. Updated April 13, 2019. Accessed June 28, 2022. https://my.clevelandclinic.org/health/diseases/10783-metabolic-syndrome
4. Centers for Disease Control and Prevention. Adult obesity facts. Updated May 17, 2022. Accessed June 28, 2022. https://www.cdc.gov/obesity/data/adult.html
5. Wu S, Zhou K, Misra-Hebert A, Bena J, Kashyap SR. Impact of metabolic syndrome on severity of COVID-19 illness. Metab Syndr Relat Disord. 2022;20(4):191-198. doi:10.1089/met.2021.0102
6. Bahinipati J, Sarangi R, Pathak M, Mohapatra S. Effect of night shift on development of metabolic syndrome among health care workers. J Family Med Prim Care. 2022;11(5):1710-1715. doi:10.4103/jfmpc.jfmpc_375_21
7. Liu L, Cai XC, Sun XY, et al. Global prevalence of metabolic syndrome in patients with psoriasis in the past two decades: current evidence. J Eur Acad Dermatol Venereol. Published online June 6, 2022. doi: 10.1111/jdv.18296