METABOLIC SYNDROME OR SYNDROME X

What is Syndrome X?

Increasingly in recent years, scientists have recognized that some heart disease risk factors cluster together in certain people. These risk factors include

1 central obesity (excessive fat tissue in the abdominal region)
2 glucose intolerance including diabetes
3 hyperlipidemia -- primarily high triglycerides and low HDL cholesterol
4 high blood pressure

This condition has been called Syndrome X or "metabolic syndrome". Many scientists think it's genetically based. The underlying cause isn't fully understood. People with Syndrome X are at higher risk of coronary artery disease.

Who has Syndrome X?

Syndrome X has been observed in people who are insulin-resistant. One such group is people with diabetes, who have a defect in insulin action and can't maintain a proper level of glucose in their blood. Another is people, mainly those with high blood pressure, who are nondiabetic and insulin-resistant but who compensate by secreting large amounts of insulin. This condition is known as hyperinsulinemia. A third group is heart attack survivors who, unlike people with hypertension, have hyperinsulinemia without having abnormal glucose levels.

Recommendation

More study is needed to understand the relationship between these risk factors. In the meantime, these steps are particularly important for patients and their doctors:

1 Monitor blood glucose, lipoproteins, and blood pressure.
2 Achieve ideal body weight and increase physical activity. Both are time-tested methods of improving insulin sensitivity, blood pressure and lipoprotein levels.
3 Treat diabetes and hyperlipidemia according to established guidelines.
4 Carefully choose drug therapy for people with high blood pressure, because different agents have different effects on insulin sensitivity.