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Metabolic Syndrome is defined as the presence of three or more of the following in patients: increased waist circumference, a high fasting blood sugar level, high triglyceride level in the blood, hypertension, and low HDL blood cholesterol level. As gastroenterologists, we see patients with metabolic syndrome because fatty liver conditions, such as Nonalcoholic Fatty Liver Disease (NAFLD) and NASH (Nonalcoholic Steatohepatitis) are extremely common in patients with metabolic syndrome.


Metabolic syndrome is linked to a condition called insulin resistance. Insulin, a hormone produced by the pancreas, assists glucose in entering the cells where it is used as energy. In patients with insulin resistance, blood glucose levels are elevated because the cells are unresponsive to Insulin. Eventually, the pancreas becomes overworked and has decreased capacity to produce insulin, resulting in an increase in glucose levels in the blood.

Risk Factors

The following factors increase your chances of having metabolic syndrome:

  • Age: Your risk of metabolic syndrome increases with age, affecting 40 percent of people over the age of 60.
  • Race: Hispanics and Asians seem to be at greater risk of metabolic syndrome than are people of other races.
  • Obesity: Carrying too much weight increases your risk of metabolic syndrome — particularly if you have an apple shape rather than a pear shape.
  • Diabetes: You're more likely to have metabolic syndrome if you had diabetes during pregnancy (gestational diabetes) or if you have a family history of type 2 diabetes.
  • Other diseases: Your risk of metabolic syndrome is higher if you've ever had cardiovascular disease, nonalcoholic fatty liver disease or polycystic ovary syndrome

Signs & Symptoms

Most often there are no physical symptoms related to metabolic syndrome. However, patients might develop associated disorders over time. If you have risk factors related to metabolic syndrome, see a health care professional to evaluate your risk.

Screenings & Diagnostic Tests

Diagnosis of Metabolic Syndrome is based on physical exam and blood test results. According to guidelines used by the National Institutes of Health, a diagnosis of metabolic syndrome requires the presence of three or more of these traits:

  • Large waist circumference. This is defined as a waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men.
  • High triglyceride level. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides).
  • Reduced HDL (good) cholesterol. An HDL cholesterol level of less than 50 mg/dL for women and less than 40 mg/dL for men (or being on medicine to treat low HDL cholesterol)
  • High Blood Pressure - A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high blood pressure)
  • High fasting blood sugar level - A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar)


Patients with metabolic syndrome are encouraged to commit to aggressive lifestyle changes including exercising regularly and maintaining a healthy, balanced diet. Doctors sometimes also suggest medications that will help control blood pressure, cholesterol levels, and blood glucose levels.

Lifestyle and Home Remedies

Aggressive lifestyle changes are usually required to prevent serious complications, such as diabetes and heart disease. These changes include:

  • Exercise. Doctors recommend getting 30 or more minutes of moderate-intensity exercise, such as brisk walking, every day.
  • Weight Loss. Losing weight can reduce insulin resistance and blood pressure and decrease your risk of diabetes.
  • Healthy Diet. The Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean diet, like many healthy-eating plans, limit unhealthy fats and emphasize fruits, vegetables, fish and whole grains. Both of these dietary approaches have been found to offer important health benefits — in addition to weight loss — for people who have components of metabolic syndrome. Either diet approach reduces the amounts of carbohydrates substantially, and many believe that carbs, particularly the fructose found in many prepared foods, colas etc is the primary culprit for the extent of obesity and metabolic syndrome in our populations.
  • Smoking Cessation. Smoking cigarettes worsen the health consequences of metabolic syndrome.

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