Metabolic Syndrome: Numbers to Know
Heart disease, stroke and diabetes are diseases I feel confident in saying all of us want to avoid. Metabolic syndrome, sometimes referred to as insulin resistance syndrome or syndrome X, is not one condition so to speak, rather a collection of 5 conditions. While there is some variance in what is included, these show up almost universally:
hypertension (high blood pressure),
elevated fasting blood glucose (blood sugar)
excess body fat around the waist,
abnormal cholesterol levels, and
elevated triglyceride levels.
Hypertension is the clinical term for high blood pressure and expressed in 2 numbers. The top number is referred to as the systolic number which captures the pressure against the arteries when your heart contracts, with the bottom being the diastolic number which represents the pressure when the heart is relaxed. While these numbers typically increase somewhat with age, the ideal reading is less than 120/80. There are stages of Hypertension which are illustrated in the link above with more context around each stage.
Elevated fasting blood glucose, or blood sugar, is defined as a reading of greater than 100 mg/dL. This is typically measured by your doctor or you may have access to a glucose monitor. Typically diet and exercise come to mind when we think of things that impact blood sugar levels and it’s important to note there are many other factors, including stress, pain, sleep, and certain medications to name a few. Another common test your doctor may request is a hemoglobin A1C (HbA1c). This captures your average blood sugar level for the past 3 months and is used to diagnose pre-diabetes and diabetes.
When it comes to waists, size does matter. Studies show in males with a waist circumference of greater than 40 inches and women with a waist measurement greater than 35 inches, size is an indicator of increased risk for health issues. This is not something typically taken by your doctor and can be easily measured at home.
Cholesterol isn’t all “bad”. You may have heard of what’s referred to as “good” cholesterol which is high-density lipoprotein or HDL. Males should aim to have an HDL of greater than 40mg/dL and women greater than 50mg/dL. On the other hand, the “bad” cholesterol is the low-density lipoprotein or LDL. Both men and women should aim to keep this number under 100.
Triglycerides, similar to LDL, are something we want to keep low as increased levels can increase the risk for heart disease. The target range for men and women is less than 150 mg/dL.
While each of these factors alone can increase the risk for cardiovascular disease, when 3 or more are present in an individual, the criteria for metabolic syndrome is met and the risk for cardiac disease, stroke and type II diabetes greatly increases. Prevention is the goal and it is important to note the conditions can be well managed and potentially reversed in some cases. The first line in prevention and treatment is…you guessed it, lifestyle modification.
As with many conditions, there are some non-modifiable risk factors such as age, race, gender and family history. While these are important to know, focusing on the modifiable risk factors is where you can really make a difference. Check out my previous blog Understanding Risk Factors to learn more about these and addressing the modifiable risk factors.
It’s important to note that medication can, and sometimes needs to be, part of a treatment plan based on what you and your doctor decide is right for you. I encourage you to talk with your doctor, express your concerns, determine realistic goals and explore treatment plans. Remember you are in the driver’s seat when it comes to your health. Having regular wellness exams to evaluate for these conditions can be a key piece in preventing metabolic syndrome. I’d like to end by acknowledging all of this is objective data which is an important part of health and that subjective data, such as stress managing, healthy coping skills, how you perceive your overall health and control over it are important factors in health and overall wellness too. More on this next month!