Metabolic syndrome: causes, symptoms, complications, treatment

The symptom complex manifested by metabolic disorders among fats and carbohydrates, high blood pressure is called metabolic syndrome or syndrome X. Patients develop obesity, leptin and insulin resistance, myocardial ischemia against the background of hypertension. What includes an algorithm for diagnosing the pathology and how it is treated, you will learn from the article.


  1. General information.
  2. Causes.
  3. Symptoms.
  4. Complications.
  5. Diagnosis.
  6. Treatment.
  7. Prognosis and prevention.

General Information

Metabolic syndrome is a group of pathologies that includes diabetes mellitus, hypertension, CHD, and obesity. The term “syndrome X” has been known since the end of the last century, it was introduced by the American Gerald Riven. According to statistics, the disease accounts for about 40% of metabolic disorders. Metabolic syndrome develops between the ages of 35 and 65 years, mostly in men. Women after menopause suffer from the pathology 5 times more often. Over the past quarter century, the number of children with this disorder has been increasing. Today it is 7%, but this is not the limit.


Metabolic syndrome is a multitrigger disease. The main reason for its development is said to be impaired cellular sensitivity to insulin. Insulin resistance is genetically determined and mediated by pancreatic pathology.

Other causes of the disease include:

  1. Eating disorders associated with leptin and ghrelin: hypercaloric diet and overeating provoke weight gain, excess of energy accumulation over energy expenditure causes accumulation of fat tissue, formation of fat depots.
  2. Lack of sufficient motor activity leads to inhibition of metabolism, obesity and insulin resistance.
  3. High blood pressure leads to poor blood circulation in the capillaries, vasospasm, changes tissue metabolism
    stress provokes endocrine disorders and inactivates leptin, which contributes to overeating.
  4. Hormonal imbalance in women during menopause is manifested by increased testosterone levels and minimization of estrogen synthesis. This becomes a trigger for slow metabolism in the body and the growth of android-type fat deposits.
  5. Hormonal imbalance in men reduces testosterone concentration after 45 and helps cumulate excess fat, provokes arterial hypertension.


The first clinical manifestations of syndrome X are considered to be rapid fatigue, apathy, inexplicable aggressiveness, and a bad mood with a feeling of hunger. As a rule, such patients prefer “fast” carbohydrates: cakes, bread, candy. Sweets buy up the bad mood. And then develops atherosclerosis, heart pain, tachycardia. Hyperinsulinemia and extra pounds lead to digestive disorders, constipation. The work of the autonomic nervous system changes, limb tremors and heart palpitations develop.

The disease is typified by thickening of the subcutaneous fat, localized fat deposits in the chest, abdomen, arms, and in the form of visceral fat surrounding the internal organs. Sharp obesity becomes the cause of stretch marks on the skin of the hips and abdomen, blood pressure jumps, its fluctuations are accompanied by nausea, headache, dry mouth, vertigo. Hyperemia of the upper half of the torso as a result of impaired vascular tone, hyperhidrosis due to malfunction of the autonomic nervous system are fixed.


Metabolic syndrome is complicated by hypertension and atherosclerosis of coronary, cerebral vessels, provokes stroke or heart attack. Insulin resistance associated with leptin resistance becomes a trigger for diabetes mellitus 2, retino- and nephropathy. In men, such a combination weakens potency and erection, while in women it causes formation of polycystic ovaries, endometriosis and minimizes libido. If the disease develops during the reproductive period, one can predict menstrual disorders, and infertility.


Metabolic syndrome has no obvious clinical manifestations, so the pathology is often diagnosed late.

The diagnostic algorithm involves:

  1. Examination by an endocrinologist, collection of anamnesis.
  2. Anthropometry: the android type of obesity is diagnosed by waist circumference – over 102 cm in men and 88 cm in women. Overweight is considered according to BMI, obesity is diagnosed when its value is more than 30.
  3. Consultation of a nutritionist and other narrow specialists, depending on the underlying comorbidities.
  4. Laboratory tests: cholesterol levels, low-density and high-density lipoproteins, triglycerides, insulin and blood glucose.

In addition, daily blood pressure monitoring, ECG, cardiac ultrasound, ultrasound of kidneys, liver, glucose tolerance test and glycemic profile are prescribed.

Differentiate X syndrome with Icenko-Cushing’s disease and syndrome, autoimmune thyroiditis, hypothyroidism, pheochromocytoma and stromal ovarian hyperplasia syndrome. In the latter case, tests for ACTH, prolactin, FSH, LH, and thyrotropic hormone levels are required.


Treatment of metabolic syndrome includes a complex of measures aimed at normalizing weight, blood pressure, hormonal balance and laboratory data. Implemented:

  1. Change of diet with the exclusion of light carbohydrates, fast food, canned foods, with restriction of salt and pasta. Daily menu includes fresh vegetables, fruits, cereals, lean fish and meat. Meals are eaten at least 6 times a day, in mini portions, without drinking water. Of drinks – green or white tea, morses, compotes without sugar.
  2. Physical activity – if there are no contraindications: running, swimming, walking, pilates, aerobics at least three times a week, exercise in the morning, walks in the park.
  3. Drugs: the goal of drug therapy is to minimize the symptoms of obesity, blood pressure, normalization of lipid and carbohydrate metabolism. Uses: Metformin and its derivatives, statins, drugs that reduce fat absorption in the intestine.

Prognosis and prevention

Timely diagnosed pathological process is a guarantee of a favorable prognosis. Late diagnosis worsens the situation, provokes serious complications from the kidneys and heart, which makes the prognosis unpredictable. As for prevention, it includes a rational diet, giving up bad habits, regular exercise. It is necessary to monitor weight and waist circumference. If there is a concomitant pathology, it is necessary to monitor the endocrinologist and control of hormonal background.



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