The Metabolic Syndrome Lives On

The metabolic syndrome was popular a decade or so ago to describe a class of patients who possessed a constellation of risk factors for diabetes and cardiovascular disease. The syndrome is a cluster of risk factors – high blood pressure, overweight, low HDL-cholesterol, and raised fasting glucose. Some expert clinicians felt that diagnosing people with the metabolic syndrome didn’t serve a useful purpose, as the individual component risk factors required individual treatment.  However, the syndrome name is still being used today to help identify people at particular risk and to demonstrate the size of the problems associated with overweight and diabetes. An example of the second use is a publication in the Canadian Medical Association Journal.  In it, University of Manitoba scientists have determined the prevalence of the metabolic syndrome in Canada.

Data was taken from the Canadian Health Measure Survey; fasting blood samples were available for measuring glucose and triglyceride levels, along with information on age, gender, weight, height, education level, and income. 

The participants were a representative sample of the Canadian population: 1,800 subjects aged 18 and above, with pregnant women excluded.  Overall, 19.1% (about one in 5 participants) had the metabolic syndrome; prevalence as age-related, being 17% in those between 18 and 39, and 39% in those aged 70 to 79.  The most common combination of factors was abdominal obesity (expanded waistline), high triglyceride levels, and low high-density lipoprotein cholesterol (HDL-C, or the ‘good’ cholesterol) levels.  People with lower education levels and lower income had a higher prevalence and more component risk-factors of the syndrome.

One in 5 seems high, but a USA study reported in JAMA in 2002 put the prevalence in the US as nearer 1 in 4.  This is clearly a serious problem for North America, and indeed many developed countries.  Individual attention to lifestyle, good diet, and physical activity would go a long way towards reducing the number of people who fall within the metabolic syndrome definition, something our family physicians should be working towards.